Provider Demographics
NPI:1508640871
Name:TRUECARE OF AUGUSTA LLC II
Entity Type:Organization
Organization Name:TRUECARE OF AUGUSTA LLC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-244-2131
Mailing Address - Street 1:550 GIBBS RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3832
Mailing Address - Country:US
Mailing Address - Phone:706-305-9748
Mailing Address - Fax:
Practice Address - Street 1:550 GIBBS RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3832
Practice Address - Country:US
Practice Address - Phone:706-305-9748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility