Provider Demographics
NPI:1356698005
Name:MADISON AT THE VALENCIA, LLC
Entity type:Organization
Organization Name:MADISON AT THE VALENCIA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-420-7971
Mailing Address - Street 1:605 SOUTH VALENCIA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707
Mailing Address - Country:US
Mailing Address - Phone:229-420-7971
Mailing Address - Fax:229-420-7971
Practice Address - Street 1:605 SOUTH VALENCIA DRIVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707
Practice Address - Country:US
Practice Address - Phone:229-420-7971
Practice Address - Fax:229-420-7971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No385H00000XRespite Care FacilityRespite Care