Wickshire Canton Opco LLC

NPI #1619516093 in Canton, Georgia

Provider Information

NPI Number
1619516093
Entity Type
Organization
Organization Name
Wickshire Canton Opco LLC
Primary Specialty
Assisted Living Facility
Enumeration Date
Jan 2, 2020
Last Updated
Jan 2, 2020

Practice Location

Address
125 RIVERSTONE TERRACE
City
Canton
State
Georgia
ZIP Code
30114
Phone
(770) 720-9669

Authorized Official

Name
MR. DANIEL OKEEFE, JD
Title
CEO
Phone
(615) 942-0240

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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