Organization
ADVENT CARE SYSTEMS OF OCILLA, LLC
Active
Organization
ADVENT CARE SYSTEMS OF OCILLA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN S. TRETTIEN (EXECUTIVE DIRECTOR)
(912) 532-9308
Entity
Organization
Contact information
Practice address
501 N IRWIN AVE, OCILLA, GA 31774-5007
(912) 433-0615
Mailing address
PO BOX 413, HINESVILLE, GA 31310-0413
(229) 468-0646
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
183500000X
Pharmacist
—
—
213E00000X
Podiatrist
—
—
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139398320
FQHC - IRWIN COUNTY LOW INCOME CERTIFICATION
GA
Enumeration date
05/27/2020
Last updated
09/16/2020
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