Provider Demographics
NPI:1780862904
Name:BRYANT ENTERPRISES INC.
Entity Type:Organization
Organization Name:BRYANT ENTERPRISES INC.
Other - Org Name:BRYANT'S OF PEACE ASISTANT LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-360-0299
Mailing Address - Street 1:339 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2585
Mailing Address - Country:US
Mailing Address - Phone:706-868-5801
Mailing Address - Fax:706-868-5801
Practice Address - Street 1:339 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-2585
Practice Address - Country:US
Practice Address - Phone:706-868-5801
Practice Address - Fax:706-868-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility