NPI 1083782288

Georgia Department of Human Resources

Organisation Intellectual Disabilities Intermediate Care Facility Augusta, GA

Practice location

Address: 100 Myrtle Blvd, Augusta, GA 30812-1500
Phone: (706) 790-2030

Authorised official

Name: Gail C Jackson
Title: Regional Hospital Administrator
Phone: (706) 790-2030

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 2121792 (GA)

Other Intermediate Care Facility, Intellectual Disabilities providers in Georgia →

Registry record

NPI: 1083782288
Entity type: Organization
NPI issued: 4 Dec 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.