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Organization

IRIS COVE PERSONAL CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE BENTLEY (OWNER)
(706) 306-0273
Entity
Organization

Contact information

Practice address
2382 WHEELESS RD, AUGUSTA, GA 30906-5404
(706) 723-5949
Mailing address
2382 WHEELESS RD, AUGUSTA, GA 30906-5404
(706) 723-5949

Taxonomy

Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
LCB20130000967
GA

Other

Enumeration date
01/30/2015
Last updated
01/30/2015
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