Provider Demographics
NPI:1023383882
Name:ASSISTED LIVING SOLUTIONS
Entity Type:Organization
Organization Name:ASSISTED LIVING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-427-8607
Mailing Address - Street 1:1178 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:GA
Mailing Address - Zip Code:31064-2111
Mailing Address - Country:US
Mailing Address - Phone:706-468-7100
Mailing Address - Fax:706-468-7090
Practice Address - Street 1:1178 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064-2111
Practice Address - Country:US
Practice Address - Phone:706-468-7100
Practice Address - Fax:706-468-7090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDGEWOOD ASSISTED LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA600112343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)