Provider Demographics
NPI:1669032405
Name:GEORGIA-LINA CARE MANAGEMENT,LLC
Entity Type:Organization
Organization Name:GEORGIA-LINA CARE MANAGEMENT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTRINO
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:GODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-426-8071
Mailing Address - Street 1:528 EDGEFIELD RD STE B
Mailing Address - Street 2:
Mailing Address - City:BELVEDERE
Mailing Address - State:SC
Mailing Address - Zip Code:29841-1942
Mailing Address - Country:US
Mailing Address - Phone:803-426-8071
Mailing Address - Fax:806-426-8144
Practice Address - Street 1:528 EDGEFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:BELVEDERE
Practice Address - State:SC
Practice Address - Zip Code:29841-1942
Practice Address - Country:US
Practice Address - Phone:803-426-8071
Practice Address - Fax:803-426-8144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health