Provider Demographics
NPI:1437287653
Name:ENGLEWOOD HEALTH CARE
Entity Type:Organization
Organization Name:ENGLEWOOD HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-435-2109
Mailing Address - Street 1:PO BOX 1743
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-1743
Mailing Address - Country:US
Mailing Address - Phone:229-435-2109
Mailing Address - Fax:229-435-0729
Practice Address - Street 1:907 N MADISON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2210
Practice Address - Country:US
Practice Address - Phone:229-435-2109
Practice Address - Fax:229-435-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000302189AMedicaid
GA000482611BMedicaid
GA000341899GMedicaid
GA000341899BMedicaid
GA000741034AMedicaid
GA000341899AMedicaid