Organization
SOUTHERN SENIOR LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH M. HARPER (CEO/ADMINSTRATOR)
(912) 383-9883
Entity
Organization
Contact information
Practice address
215 SELLERS ST, DOUGLAS, GA 31533-4609
(912) 383-9883
(912) 383-8571
Mailing address
215 SELLERS ST, DOUGLAS, GA 31533-4609
(912) 383-9883
(912) 383-8571
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
034-01-011-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390875605A
—
GA
Enumeration date
07/07/2010
Last updated
07/07/2010
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