Healthcare Provider Details

I. General information

NPI: 1154154086
Provider Name (Legal Business Name): DUBLIN TRAILS OF JOURNEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1634 TELFAIR ST
DUBLIN GA
31021-3115
US

IV. Provider business mailing address

1634 TELFAIR ST
DUBLIN GA
31021-3115
US

V. Phone/Fax

Practice location:
  • Phone: 478-272-1133
  • Fax: 478-272-4401
Mailing address:
  • Phone: 478-272-1133
  • Fax: 478-272-4401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. BERNARD J MCGUINNESS III
Title or Position: MANAGER
Credential:
Phone: 317-523-4786