Provider Demographics
NPI:1639568025
Name:GEORGIA'S PLACE INC.
Entity Type:Organization
Organization Name:GEORGIA'S PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:LEMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-896-6070
Mailing Address - Street 1:2101 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-2723
Mailing Address - Country:US
Mailing Address - Phone:727-896-6070
Mailing Address - Fax:
Practice Address - Street 1:2101 7TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-2723
Practice Address - Country:US
Practice Address - Phone:727-896-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8966310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility