| NPI | 1912261231 |
|---|---|
| Doing Business As | LONGEVITY PERSONAL CARE HOME |
| Entity Type | Organization |
| Authorized Contact | CALETHA TAYLOR Manager 706-951-7514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |