Healthcare Provider Details

I. General information

NPI: 1609513860
Provider Name (Legal Business Name): SAXON PCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 PINEY GROVE RD
AUGUSTA GA
30906-8714
US

IV. Provider business mailing address

27 MOUNTAIN AVE
COLD SPRING NY
10516-1804
US

V. Phone/Fax

Practice location:
  • Phone: 706-793-8242
  • Fax:
Mailing address:
  • Phone: 646-221-7080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ARAHM LEE
Title or Position: MANAGER
Credential:
Phone: 646-221-7080