Organization
IVYDALE AT WILLOW LODGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENI AKRIDGE (ADMINISTRATOR)
(229) 668-4721
Entity
Organization
Contact information
Practice address
3120 S MAIN ST, MOULTRIE, GA 31768-6702
(229) 668-4721
Mailing address
3120 S MAIN ST, MOULTRIE, GA 31768-6702
(229) 668-4721
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PCH008684
GA
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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