Provider Demographics
NPI:1699179416
Name:TREATED EXCELLENT HEALTHCARE LLC.
Entity Type:Organization
Organization Name:TREATED EXCELLENT HEALTHCARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-418-7328
Mailing Address - Street 1:753 BRIDLE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30011-4654
Mailing Address - Country:US
Mailing Address - Phone:209-418-7328
Mailing Address - Fax:404-585-3554
Practice Address - Street 1:753 BRIDLE CREEK WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:GA
Practice Address - Zip Code:30011-4654
Practice Address - Country:US
Practice Address - Phone:209-418-7328
Practice Address - Fax:404-585-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility