Organization
INEPENDENT LIVING CARE
Active
Other names
INEPENDENT LIVING CARE
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANN JERNIGAN (CEO)
(912) 202-6344
Entity
Organization
Contact information
Practice address
134 BROWN ST, SCREVEN, GA 31560-9134
(912) 202-3674
Mailing address
134 BROWN STREET, P O BOX 494, SCREVEN, GA 31560
(912) 202-6344
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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