Organization
WILLIAM C BYRD INC
Active
Other names
Grace Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM C BYRD (OWNER PRESIDENT)
(229) 382-8655
Entity
Organization
Contact information
Practice address
405 NORTH RIDGE AVENUE, TIFTON, GA 31794
(229) 387-0940
(229) 382-7011
Mailing address
PO BOX 890, TIFTON, GA 31793
(229) 382-8655
(229) 382-7011
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00747766D
—
GA
Enumeration date
12/04/2006
Last updated
08/22/2020
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