Provider Demographics
NPI:1336229863
Name:MEDICAL MANAGEMENT CONCEPTS LLC
Entity Type:Organization
Organization Name:MEDICAL MANAGEMENT CONCEPTS LLC
Other - Org Name:MOUNTAIN VIEW HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-974-0006
Mailing Address - Street 1:547 WARWOMAN RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525
Mailing Address - Country:US
Mailing Address - Phone:706-782-4276
Mailing Address - Fax:706-782-1516
Practice Address - Street 1:547 WARWOMAN RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525
Practice Address - Country:US
Practice Address - Phone:706-782-4276
Practice Address - Fax:706-782-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11197192314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00143184AMedicaid
GA115688Medicare Oscar/Certification