Provider Demographics
NPI:1154154086
Name:DUBLIN TRAILS OF JOURNEY LLC
Entity type:Organization
Organization Name:DUBLIN TRAILS OF JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGUINNESS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:317-523-4786
Mailing Address - Street 1:1634 TELFAIR ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3115
Mailing Address - Country:US
Mailing Address - Phone:478-272-1133
Mailing Address - Fax:478-272-4401
Practice Address - Street 1:1634 TELFAIR ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3115
Practice Address - Country:US
Practice Address - Phone:478-272-1133
Practice Address - Fax:478-272-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility