Green Terrace

NPI #1598884835 in Moultrie, Georgia

Provider Information

NPI Number: 1598884835
Entity Type: Organization
Organization Name: Green Terrace
Primary Specialty: Assisted Living Facility
Enumeration Date: Mar 28, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 821 26TH AVE SE
City: Moultrie
State: Georgia
ZIP Code: 31768-6769
Phone: (229) 985-0905

Authorized Official

Name: MR. THOMAS W GREENE
Title: OWNER
Phone: (229) 985-0905

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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