Provider Demographics
NPI:1255966081
Name:WESTMINSTER PRESBYTERIAN HOMES, INC.
Entity type:Organization
Organization Name:WESTMINSTER PRESBYTERIAN HOMES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRENDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-263-6194
Mailing Address - Street 1:PO BOX 926
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31643-0926
Mailing Address - Country:US
Mailing Address - Phone:229-263-6106
Mailing Address - Fax:229-263-6195
Practice Address - Street 1:1400 LIVE OAK LN
Practice Address - Street 2:BUILDING 100
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:678-301-4906
Practice Address - Fax:706-739-7516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251J00000XAgenciesNursing Care
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
115775OtherMEDICARE
1255966081OtherNPI
GALTC001014OtherGEORGIA NURSING HOME PERMIT
GAALC000684OtherGEORGIA ASSISTED LIVING PERMIT