Pecan Manor Iii

LBN: Georgia Dept Of Human Resources
Pecan Manor Iii is an health care organization with primary practice located at 451 Boland Cir , Milledgeville GA 31062-7525. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Georgia Dept Of Human Resources can be contacted via phone (478) 445-4128, or through Bailey, Marvin via phone (478) 445-4128.

Contact Information

Primary practice address
451 Boland Cir Milledgeville GA 31062-7525
Phone: (478) 445-4128
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bailey, Marvin
Phone: (478) 445-4128

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1871606178
LBN Legal business name Georgia Dept Of Human Resources
DBA Doing business as Pecan Manor Iii
Authorized official Bailey, Marvin
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871606178 NPPES
Georgia MEDICAID 00142403A

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