Organization
PLACE AT AUGUSTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN R MCGUIRE CPA (REIMBURSEMENT MANAGER)
(404) 641-1919
Entity
Organization
Contact information
Practice address
820 STEVENS CREEK RD, AUGUSTA, GA 30907-9251
(706) 860-6622
Mailing address
820 STEVENS CREEK RD, AUGUSTA, GA 30907-9251
(706) 860-6622
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
11211847
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000213463A
—
GA
Enumeration date
06/10/2008
Last updated
06/10/2008
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