Healthcare Provider Details

I. General information

NPI: 1669315057
Provider Name (Legal Business Name): EASTMAN TRAILS OF JOURNEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 CHESTER HWY
EASTMAN GA
31023-3717
US

IV. Provider business mailing address

556 CHESTER HWY
EASTMAN GA
31023-3717
US

V. Phone/Fax

Practice location:
  • Phone: 478-374-4733
  • Fax:
Mailing address:
  • Phone: 478-374-4733
  • Fax:

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: BERNARD J MCGUINNESS
Title or Position: MEMBER OF LLC
Credential:
Phone: 317-523-4786