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General NPI Number Information
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NPI Number | 1336318286
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Entity Type | Organization
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Legal Business Name | AUTUMNCARE HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 211 E 7TH ST
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City | WAYNESBORO
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State | GA
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Zip | 30830-1408
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Country | US
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Telephone | 706-526-4378
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Fax | 706-526-4378
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Provider Business Mailing Address
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Address Line | 342 BARNSLEY DR
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City | EVANS
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State | GA
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Zip | 30809-8235
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Country | US
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Telephone | 706-210-7288
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PAT P MADRAY
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Credential |
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Telephone | 706-526-4378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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