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General NPI Number Information
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NPI Number | 1891850061
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Entity Type | Organization
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Legal Business Name | AUTUMNCARE ADULT DAY CENTER, INC.
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3654 J DEWEY GRAY CIR
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City | AUGUSTA
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State | GA
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Zip | 30909-6424
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Country | US
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Telephone | 706-863-9888
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Fax | 706-863-7277
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Provider Business Mailing Address
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Address Line | 3654 J DEWEY GRAY CIR
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City | AUGUSTA
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State | GA
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Zip | 30909-6424
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Country | US
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Telephone | 706-863-9888
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Fax | 706-863-7277
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PAT P. MADRAY
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Credential |
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Telephone | 706-863-9888
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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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