Provider Demographics
NPI:1225899255
Name:EASY LIVING CARE HOME INC
Entity Type:Organization
Organization Name:EASY LIVING CARE HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:TURNER
Authorized Official - Last Name:HARDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-235-0000
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:UNADILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31091-0084
Mailing Address - Country:US
Mailing Address - Phone:478-627-9022
Mailing Address - Fax:
Practice Address - Street 1:301 EAST BEACHAM AVE
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:GA
Practice Address - Zip Code:31091
Practice Address - Country:US
Practice Address - Phone:478-627-9022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility