NPI 1619403805

Quencie's Manor LLC

Organisation Physical Disabilities Residential Treatment Facility Macon, GA

Practice location

Address: 2104 Jeffersonville Rd, Macon, GA 31217-4517
Phone: (478) 832-5479
Fax: (478) 239-5148

Authorised official

Name: Joseph Andrews
Title: Administator
Phone: (478) 832-5479

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence PCH009157 (GA)

Other Residential Treatment Facility, Physical Disabilities providers in Georgia →

Registry record

NPI: 1619403805
Entity type: Organization
NPI issued: 7 May 2017
Record last updated: 7 May 2017

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.