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Organization

SPRING VILLA PERSONAL CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. EMOGENE TOMPKINS (DIRECTOR)
(478) 742-0972
Entity
Organization

Contact information

Practice address
620 MONROE ST, MACON, GA 31201-1422
(478) 742-0972
Mailing address
620 MONROE ST, MACON, GA 31201-1422
(478) 742-0972

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
011020151
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00454968A
GA
Enumeration date
04/03/2007
Last updated
08/12/2008
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