Healthcare Provider Details
I. General information
NPI: 1851974869
Provider Name (Legal Business Name): ALICE'S PLACE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2021
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3780 NAPIER AVE
MACON GA
31204-2753
US
IV. Provider business mailing address
3780 NAPIER AVE
MACON GA
31204-2753
US
V. Phone/Fax
- Phone: 478-254-7171
- Fax: 478-254-9736
- Phone: 478-254-7171
- Fax: 478-254-9736
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
F
DUNCAN
Title or Position: OWNER
Credential: RN
Phone: 478-718-7331