Organization
SOUTHERN LIVING ACADEMY PCH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA SHEILDS (EXECTIVE DIRECTOR)
(706) 536-2889
Entity
Organization
Contact information
Practice address
4225 ALTON STRRET, COLUMBUS, GA 31903
(706) 536-2889
Mailing address
4225 ALTON ST, COLUMBUS, GA 31903-2322
(706) 536-2889
(762) 821-2274
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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