Healthcare Provider Details

I. General information

NPI: 1801833231
Provider Name (Legal Business Name): LILLIAN G. CARTER NURSING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HOSPITAL ST
PLAINS GA
31780-5544
US

IV. Provider business mailing address

225 HOSPITAL ST
PLAINS GA
31780-5544
US

V. Phone/Fax

Practice location:
  • Phone: 229-824-7796
  • Fax: 229-824-7800
Mailing address:
  • Phone: 229-824-7796
  • Fax: 229-824-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1-129-1714
License Number StateGA

VIII. Authorized Official

Name: JESSICA SEARCY
Title or Position: ADMINISTRATOR
Credential:
Phone: 229-824-7796