MIONA GERIATRIC AND DEMENTIA CENTER, LLC
NPI 1174770424
Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition in Ideal, GA

Active since August 19, 2008CLIA 11D0263610 · Waiver
201 POPLAR ST, IDEAL, GA 31041(478) 949-2270 Get Directions Write a Review

NPPES record last updated: October 27, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Miona Geriatric And Dementia Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIONA GERIATRIC AND DEMENTIA CENTER, LLC (NPI 1174770424) is a healthcare organization registered as a parenteral & enteral nutrition in Ideal, Georgia and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists William Jule Windham, President, as its authorized official.

NPPES Registry Identity

NPI1174770424
Entity TypeOrganization
Primary Taxonomy332BP3500X
Legal Business NameMIONA GERIATRIC AND DEMENTIA CENTER, LLC
Location Address201 POPLAR STIdeal, GA 31041-6264
Mailing Address777 Nursing Home RdMarshallville, GA 31057-3715 · (478) 967-2223
Organization SubpartNo
Authorized OfficialWilliam Jule WindhamPresident · (478) 967-2223
Enumeration DateAugust 19, 2008
Last NPPES UpdateOctober 27, 2008
NPI 1174770424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

201 POPLAR ST, Ideal, GA 31041

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0263610

Miona Geriatric And Dementia Center · Ideal, GA
Active · expires Aug 31, 2026
CLIA Number11D0263610
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorChristopher Richards
Laboratory Phone(478) 949-2270
Laboratory LocationMiona Geriatric And Dementia Center201 Poplar Street, Ideal, GA 31041
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
201 POPLAR ST
IDEAL, GA 31041
Family Medicine
201 POPLAR ST
IDEAL, GA 31041
Skilled Nursing Facility
201 POPLAR ST
IDEAL, GA 31041
Occupational Therapy Assistant
201 POPLAR ST
IDEAL, GA 31041

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miona Geriatric And Dementia Center, LLC's NPI number?

The NPI number for Miona Geriatric And Dementia Center, LLC is 1174770424. It was assigned to this organization in the NPPES registry on August 19, 2008.

Where is Miona Geriatric And Dementia Center, LLC located?

Miona Geriatric And Dementia Center, LLC is located at 201 Poplar St, Ideal, GA 31041. The listed phone number is (478) 949-2270.

What is Miona Geriatric And Dementia Center, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Parenteral & Enteral Nutrition, with taxonomy code 332BP3500X.

Does Miona Geriatric And Dementia Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0263610) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Miona Geriatric And Dementia Center, LLC was last updated on October 27, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.