Provider Demographics
NPI:1134864853
Name:LAGRANGE OPERATIONS LLC
Entity type:Organization
Organization Name:LAGRANGE OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-368-4402
Mailing Address - Street 1:2111 W POINT RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-4047
Mailing Address - Country:US
Mailing Address - Phone:706-812-9293
Mailing Address - Fax:706-882-9506
Practice Address - Street 1:2111 W POINT RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4047
Practice Address - Country:US
Practice Address - Phone:706-812-9293
Practice Address - Fax:706-882-9506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility