Provider Demographics
NPI:1427224153
Name:WILKINSON PERSONAL CARE HOME
Entity type:Organization
Organization Name:WILKINSON PERSONAL CARE HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-282-4200
Mailing Address - Street 1:269 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-7846
Mailing Address - Country:US
Mailing Address - Phone:706-282-2977
Mailing Address - Fax:
Practice Address - Street 1:269 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-7846
Practice Address - Country:US
Practice Address - Phone:706-282-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHENS COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-02
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA127030011310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility