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PARK REGENCY OF MOULTRIE
NPI 1881915338
Assisted Living Facility in Moultrie, GA

Active since June 18, 2010
3000 VETERANS PKWY S, MOULTRIE, GA 31788(229) 890-3342(229) 891-3355 Get Directions Write a Review

NPPES record last updated: June 18, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Park Regency Of Moultrie NPPES

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

PARK REGENCY OF MOULTRIE (NPI 1881915338) is a healthcare organization registered as an assisted living facility in Moultrie, Georgia and active in the NPI registry since June 2010. The organization lists Gary Blake, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1881915338
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameMOULTRIE I ENTERPRISES, LLC
Location Address3000 VETERANS PKWY SMoultrie, GA 31788-7762
Mailing Address3000 Veterans Pkwy SMoultrie, GA 31788-7762 · (229) 890-3342 · Fax (229) 891-3355
Phone(229) 890-3342
Fax(229) 891-3355
Organization SubpartNo
Authorized OfficialGary BlakeManaging Member · (817) 348-8841
Enumeration DateJune 18, 2010
✔ NPI 1881915338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
3000 VETERANS PKWY S, Moultrie, GA 31788
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Other Names 1

Doing Business AsPark Regency Of Moultrie

Other Providers at the Same Location NPPES

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

EBONY D STUBBINS FNP
Nurse Practitioner (Family)
3000 VETERANS PKWY S
MOULTRIE, GA 31788
Colquitt County (229) 985-3422

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 Moultrie I Enterprises, LLC's NPI number?

The NPI number for Moultrie I Enterprises, LLC is 1881915338. It was assigned to this organization in the NPPES registry on June 18, 2010. The provider is doing business as Park Regency Of Moultrie.

Where is Moultrie I Enterprises, LLC located?

Moultrie I Enterprises, LLC is located at 3000 Veterans Pkwy S, Moultrie, GA 31788. The listed phone number is (229) 890-3342.

What is Moultrie I Enterprises, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Moultrie I Enterprises, LLC was last updated on June 18, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.