Provider Demographics
NPI:1114124179
Name:MEDICAL MANAGEMENT CONCEPTS LLC
Entity Type:Organization
Organization Name:MEDICAL MANAGEMENT CONCEPTS LLC
Other - Org Name:GOLD CITY PERSONAL CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CHANCIE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-405-0454
Mailing Address - Street 1:5402 NEW FORSYTH RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-0883
Mailing Address - Country:US
Mailing Address - Phone:478-405-0454
Mailing Address - Fax:478-405-7163
Practice Address - Street 1:350 MOORES DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0442
Practice Address - Country:US
Practice Address - Phone:706-864-3136
Practice Address - Fax:706-864-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility