Organization
GEORGIA TUCKER LLC
Active
Other names
The Gardens at Georgia Tucker
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE COBURN (COO)
(318) 789-2001
Entity
Organization
Contact information
Practice address
405 STUBBS AVE, MONROE, LA 71201-5505
(318) 538-0040
Mailing address
414 PINE ST, MONROE, LA 71201-6228
(318) 699-8819
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1709581
—
LA
Enumeration date
04/12/2021
Last updated
04/12/2021
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