Provider Demographics
NPI:1871286161
Name:GEORGINA BOARD & CARE, INC.
Entity type:Organization
Organization Name:GEORGINA BOARD & CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:V
Authorized Official - Last Name:MOTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-913-6290
Mailing Address - Street 1:77 GEORGINA ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-6121
Mailing Address - Country:US
Mailing Address - Phone:619-913-6290
Mailing Address - Fax:619-934-5320
Practice Address - Street 1:77 GEORGINA ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-6121
Practice Address - Country:US
Practice Address - Phone:619-913-6290
Practice Address - Fax:619-934-5320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home