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General NPI Number Information
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NPI Number | 1932959285
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Entity Type | Organization
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Legal Business Name | LILLIE'S ADULT DAY CARE, LLC
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 3755 BLOOMFIELD RD STE 12B
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City | MACON
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State | GA
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Zip | 31206-3655
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Country | US
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Telephone | 478-216-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 5120 NISBET DR
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City | MACON
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State | GA
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Zip | 31206-4724
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Country | US
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Telephone | 478-508-9247
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIKA J THOMAS
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Credential |
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Telephone | 478-508-9247
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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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