Healthcare Provider Details

I. General information

NPI: 1558318337
Provider Name (Legal Business Name): LANIER HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 W THIGPEN AVE
LAKELAND GA
31635-1006
US

IV. Provider business mailing address

852 W THIGPEN AVE
LAKELAND GA
31635-1006
US

V. Phone/Fax

Practice location:
  • Phone: 229-482-3110
  • Fax: 229-482-8542
Mailing address:
  • Phone: 229-482-3110
  • Fax: 229-482-8542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number10861322
License Number StateGA

VIII. Authorized Official

Name: MR. NEIL W. GINTY
Title or Position: ADMINISTRATOR
Credential:
Phone: 229-482-8402