Provider Demographics
NPI:1962771147
Name:THE KNIGHT GROUP INCORPORATED OF GEORGIA
Entity type:Organization
Organization Name:THE KNIGHT GROUP INCORPORATED OF GEORGIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINSRTATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:KNIGHT
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-762-3150
Mailing Address - Street 1:382 JOWERS RD
Mailing Address - Street 2:PO BOX 409
Mailing Address - City:WHIGHAM
Mailing Address - State:GA
Mailing Address - Zip Code:39897-2162
Mailing Address - Country:US
Mailing Address - Phone:229-762-3150
Mailing Address - Fax:229-762-3110
Practice Address - Street 1:382 JOWERS RD
Practice Address - Street 2:
Practice Address - City:WHIGHAM
Practice Address - State:GA
Practice Address - Zip Code:39897-2162
Practice Address - Country:US
Practice Address - Phone:229-762-3150
Practice Address - Fax:229-762-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-18
Last Update Date:2011-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065010161251E00000X, 261QA0600X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No305S00000XManaged Care OrganizationsPoint of Service