Provider Demographics
NPI:1134516339
Name:ANNIE MAES HEALTH CARE SERVICES LLC.
Entity Type:Organization
Organization Name:ANNIE MAES HEALTH CARE SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MESHA
Authorized Official - Middle Name:D'ANNA NICHOLE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-833-8297
Mailing Address - Street 1:1140 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-4160
Mailing Address - Country:US
Mailing Address - Phone:706-833-8297
Mailing Address - Fax:
Practice Address - Street 1:1140 14TH AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-4160
Practice Address - Country:US
Practice Address - Phone:706-833-8297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-25
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility