Provider Demographics
NPI:1528000825
Name:ACTS RETIREMENT-LIFE COMMUNITIES, INC.
Entity Type:Organization
Organization Name:ACTS RETIREMENT-LIFE COMMUNITIES, INC.
Other - Org Name:WILLOWBROOKE COURT AT LANIER VILLAGE ESTATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-661-8330
Mailing Address - Street 1:420 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2711
Mailing Address - Country:US
Mailing Address - Phone:215-661-8330
Mailing Address - Fax:215-661-8316
Practice Address - Street 1:4000 VILLAGE VIEW DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-4331
Practice Address - Country:US
Practice Address - Phone:678-450-3000
Practice Address - Fax:678-450-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-069-1740313M00000X
GA10691740314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
582440835OtherTRI-CARE
582440835OtherHUMANA
115687Medicare ID - Type Unspecified