Organization
FALCON CREST MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS L. KINDELIN RN (OWNER)
(478) 456-4758
Entity
Organization
Contact information
Practice address
111 EPPS ST, GORDON, GA 31031-3805
(478) 628-1126
(478) 628-1026
Mailing address
PO BOX 100, GORDON, GA 31031-0100
(478) 628-1126
(478) 628-1026
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
158030011
GA
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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