Organization
LAKEVIEW MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES E PETERSON (OWNER)
(770) 267-5511
Entity
Organization
Contact information
Practice address
1321 PRICE MILL RD, MADISON, GA 30650-2867
(706) 342-7159
Mailing address
1321 PRICE MILL RD, MADISON, GA 30650-2867
(706) 342-7159
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
GA
Other
Enumeration date
12/28/2006
Last updated
08/22/2020
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