MEDICARE: WHISPERING PINES ASSISTED LIVING FACILITY, LLC

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	:	1881653764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHISPERING PINES ASSISTED LIVING FACILITY, LLC

Provider Business Mailing Address
First Line	:	100 E PACES DR
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30605-5217
Country	:	US
Telephone Number	:	706-354-6540
Fax Number	:	706-354-3225

Provider Business Practice Location Address
First Line	:	100 E PACES DR
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30605-5217
Country	:	US
Telephone Number	:	706-354-6540
Fax Number	:	706-354-3225

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. DEBRA J SHERRER
Credential	:
Telephone Number	:	706-354-6540

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	10/25/2007

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