The Pavilion At Brandon Wilde

LBN: Lcs Brandon Wilde Llc
The Pavilion At Brandon Wilde is an health care organization with primary practice located at 4275 Owens Rd , Evans GA 30809. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Lcs Brandon Wilde Llc can be contacted via phone (706) 868-9800, or through Bridgewater, Diane C via phone (515) 875-4500.

Contact Information

Primary practice address
4275 Owens Rd Evans GA 30809
Phone: (706) 868-9800
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bridgewater, Diane C
Phone: (515) 875-4500

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 1-036-2130 Georgia

Profile Details

NPI number 1821580440
LBN Legal business name Lcs Brandon Wilde Llc
DBA Doing business as The Pavilion At Brandon Wilde
Authorized official Bridgewater, Diane C
Entity Organization
Organization subpart 1 No
Enumeration date May 30th, 2018
Last updated Jun 19th, 2019 - about 5 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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