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1982912721
EQUILLA W BRACKETT
JENKINSBURG, GA
NPI
1982912721
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
310400000X Assisted Living Facility
(Licence: GA 018-01-008-1)
Enumeration Date
2010-09-15
Last Update Date
2010-09-15
Business Address
-- EQUILLA W BRACKETT
379 COUNTY LINE RD
JENKINSBURG, GA 30234-2313
Phone number: 770-775-6949
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Mailing Address
-- EQUILLA W BRACKETT
379 COUNTY LINE RD
JENKINSBURG, GA 30234-2313
Phone number: 770-775-6949
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