Provider Demographics
NPI:1225766322
Name:RICHLAND ADULT DAY CENTER, LLC
Entity Type:Organization
Organization Name:RICHLAND ADULT DAY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-566-9587
Mailing Address - Street 1:5633 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-6738
Mailing Address - Country:US
Mailing Address - Phone:706-566-4607
Mailing Address - Fax:
Practice Address - Street 1:581 ALSTON ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:GA
Practice Address - Zip Code:31825-6011
Practice Address - Country:US
Practice Address - Phone:229-384-2009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000000000Medicaid