Provider Demographics
NPI:1659432326
Name:BETTY SAXON ELDER CARE
Entity Type:Organization
Organization Name:BETTY SAXON ELDER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-793-8242
Mailing Address - Street 1:1125 PINEY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-8714
Mailing Address - Country:US
Mailing Address - Phone:706-793-8242
Mailing Address - Fax:706-793-2272
Practice Address - Street 1:1125 PINEY GROVE RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-8714
Practice Address - Country:US
Practice Address - Phone:706-793-8242
Practice Address - Fax:706-793-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA121-03-017-1302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000921434BMedicaid
GA000921434AMedicaid