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General NPI Number Information
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NPI Number | 1902142292
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Entity Type | Organization
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Legal Business Name | HILL'S HOUSE PERSONAL CARE HOME
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 4745 MIKE PADGETT HWY
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City | AUGUSTA
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State | GA
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Zip | 30906-9731
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Country | US
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Telephone | 706-877-4907
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Fax |
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Provider Business Mailing Address
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Address Line | 4745 MIKE PADGETT HWY
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City | AUGUSTA
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State | GA
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Zip | 30906-9731
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Country | US
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Telephone | 706-877-4907
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BILLIE M HILL
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Credential |
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Telephone | 706-877-4901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | #LCB20100001016
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License Number State | GA
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