Provider Demographics
NPI:1083215842
Name:STEWART COMMUNITY HOME, INC.
Entity Type:Organization
Organization Name:STEWART COMMUNITY HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:JOELLE
Authorized Official - Last Name:VINZANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-7030
Mailing Address - Street 1:PO BOX 4279
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31914-0279
Mailing Address - Country:US
Mailing Address - Phone:706-341-7750
Mailing Address - Fax:
Practice Address - Street 1:1125 15TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2219
Practice Address - Country:US
Practice Address - Phone:706-507-7030
Practice Address - Fax:706-327-9507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness