Provider Demographics
NPI:1316024821
Name:GENERATIONS ADULT DAY SERVICES,INC.
Entity Type:Organization
Organization Name:GENERATIONS ADULT DAY SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:BEVERLY
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-318-2260
Mailing Address - Street 1:2463 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31206-2149
Mailing Address - Country:US
Mailing Address - Phone:478-318-2260
Mailing Address - Fax:478-471-8847
Practice Address - Street 1:2463 2ND ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206-2149
Practice Address - Country:US
Practice Address - Phone:478-318-2260
Practice Address - Fax:478-471-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011-R-0038251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health