Organization
MADISON HOUSE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT MIGUEL PERERA (OWNER)
(706) 342-4514
Entity
Organization
Contact information
Practice address
3910 DIXIE HWY, MADISON, GA 30650-3431
(706) 474-3722
(706) 557-0203
Mailing address
167 W JEFFERSON ST, MADISON, GA 30650-1367
(706) 342-4514
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
104030011
GA
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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