Gracemore, Llc

NPI 1477542991 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1477542991
Enumeration Date 10/18/2005
Last Updated 04/13/2012
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name WILLIAM C. WILLIAM
Position PRESIDENT
Phone (912) 265-6771
Fax (912) 264-8988
Practice Location
2708 LEE ST
BRUNSWICK GA, 31520-4932, US
Phone (912) 265-6771
Fax (912) 264-8988
Business Location
1211 MACON RD
STE D
PERRY GA, 31069-2679, US
Phone (478) 988-1294
Fax (478) 988-1193
Toxanomy
Taxonomy Code 314000000X
License State Georgia
License Number 10631320
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According to our database, Gracemore, Llc NPI is 1477542991, taxonomy code is 314000000X and license number is 10631320, license state is located at Georgia. Gracemore, Llc physically located at 2708 Lee St, Brunswick GA, 31520-4932. NPI Number 1033115704 has the healthcare provider type.

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1477542991 NPI number is provided on an as is basis without warranty of any kind. 1477542991 is maintained by the National Plan & Provider Enumeration System. The contents of Gracemore, Llc are for informational purposes only.