MEDICARE: LEISURE LIVING, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility		GA

General Provider Information

NPI Number	:	1396883252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEISURE LIVING, INC

Provider Business Mailing Address
First Line	:	1105 MOUNT VERNON RD
Second Line	:	PO. BOX 561
City	:	VIDALIA
State	:	GA
Zip	:	30474-3002
Country	:	US
Telephone Number	:	912-537-9306
Fax Number	:	912-538-5509

Provider Business Practice Location Address
First Line	:	1105 MOUNT VERNON RD
Second Line	:
City	:	VIDALIA
State	:	GA
Zip	:	30474-3002
Country	:	US
Telephone Number	:	912-537-9306
Fax Number	:	912-538-5509

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. JOETTE H. GAY
Credential	:	R.N.
Telephone Number	:	912-537-9306

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1336178532 — HOSPICE HELP LLC
Practice Location Address:

3002 CARTER ST
VIDALIA, LA
71373-3012

Practice Phone: 318-336-8989
Practice Fax: 318-336-9876

1972293777 — DR. ASHLEY MAKALA DMD
Practice Location Address:

118 ALICE COLEMAN DR
VIDALIA, GA
30474-8860

Practice Phone: 912-537-6565
Practice Fax:

1750222717 — PRUITTHEALTH HOME HEALTH SOUTH GEORGIA, INC
Practice Location Address:

806 MAPLE DR
VIDALIA, GA
30474-7208

Practice Phone: 770-279-6200
Practice Fax:

1417873324 — JENNIFER J JONES FNP
Practice Location Address:

500 MAPLE DR
VIDALIA, GA
30474-8998

Practice Phone: 912-535-3500
Practice Fax:

1447185129 — PAIN TREATMENT CENTERS OF GEORGIA LLC
Practice Location Address:

303 HARRIS INDUSTRIAL BLVD
VIDALIA, GA
30474-8853

Practice Phone: 912-910-3777
Practice Fax: 912-292-0005

1699600874 — VIDALIA HEALTH SERVICES, LLC
Practice Location Address:

1707 MEADOWS LN STE B
VIDALIA, GA
30474-7201

Practice Phone: 912-535-7100
Practice Fax:

Directions to “LEISURE LIVING, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.