Provider Demographics
NPI:1912067372
Name:BARBARA RAY HALL PERSONAL CARE HOME
Entity Type:Organization
Organization Name:BARBARA RAY HALL PERSONAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-793-7900
Mailing Address - Street 1:2638 CASTLETOWN DR
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-6556
Mailing Address - Country:US
Mailing Address - Phone:706-793-7900
Mailing Address - Fax:706-793-6714
Practice Address - Street 1:2638 CASTLETOWN DR
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-6556
Practice Address - Country:US
Practice Address - Phone:706-793-7900
Practice Address - Fax:706-793-6714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility