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General NPI Number Information
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NPI Number | 1760777494
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Entity Type | Organization
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Legal Business Name | NEW HEIGHTS PERSONAL CARE HOMES, LLC
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 509 POTTERSTONE SQUARE
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City | POOLER
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State | GA
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Zip | 31322-4529
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Country | US
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Telephone | 912-272-9568
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Fax | 912-826-1847
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Provider Business Mailing Address
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Address Line | 419 FLINT DR
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City | RINCON
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State | GA
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Zip | 31326-4529
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Country | US
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Telephone | 912-272-9568
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Fax | 912-826-1847
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. TRINITY HEIGHT
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Credential | M.A
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Telephone | 912-272-9568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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