Organization
MACKLANDER, LLC
Active
Organization
MACKLANDER, LLC
Active
Parent organization
MACKLANDER, LLC
Other names
Macksimum Alliance
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACKLANDER, LLC
Authorized official
MRS. SHELLEY DIANE MACK (ADMINISTRATOR)
(706) 854-0555
Entity
Organization
Contact information
Practice address
1514 BALDWIN LAKES DR, GROVETOWN, GA 30813-5887
(706) 854-0555
(706) 651-9677
Mailing address
1514 BALDWIN LAKES DR, GROVETOWN, GA 30813-5887
(706) 854-0555
(706) 651-9677
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
036-R-0525
GA
261QD1600X
Developmental Disabilities Clinic/Center
Primary
036-R-0525
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366878280A
—
GA
05
—
366878280B
—
GA
Enumeration date
01/28/2013
Last updated
01/28/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up