Healthcare Provider Details

I. General information

NPI: 1437287653
Provider Name (Legal Business Name): ENGLEWOOD HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 N MADISON ST
ALBANY GA
31701-2210
US

IV. Provider business mailing address

PO BOX 1743
ALBANY GA
31702-1743
US

V. Phone/Fax

Practice location:
  • Phone: 229-435-2109
  • Fax: 229-435-0729
Mailing address:
  • Phone: 229-435-2109
  • Fax: 229-435-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOYCE BARLOW
Title or Position: CEO
Credential:
Phone: 229-435-2109