Provider Demographics
NPI:1437372844
Name:THE MADISON
Entity Type:Organization
Organization Name:THE MADISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-430-7971
Mailing Address - Street 1:1604 LILY POND RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-7760
Mailing Address - Country:US
Mailing Address - Phone:229-869-9584
Mailing Address - Fax:220-429-7971
Practice Address - Street 1:501 S MADISON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-3113
Practice Address - Country:US
Practice Address - Phone:229-420-7971
Practice Address - Fax:229-420-7971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility