Equilla W Brackett Valid NPI
Individual provider · Assisted Living Facility · Jenkinsburg, GA
- NPI
- 1982912721
- Type
- Individual (Type 1)
- Primary specialty
- Assisted Living Facility
- Specialty group
- Nursing & Custodial Care Facilities
- Taxonomy code
- 310400000X
- License number
- 018-01-008-1 (GA)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2010-09-15
- Last updated
- 2010-09-15
Practice location
379 County Line Rd
Jenkinsburg, GA 30234-2313
(770) 775-6949