OrganizationActive
Moultrie I Enterprises, LLC
NPI 1881915338 · Assisted Living Facility · Moultrie, GA
Provider details
- NPI number
- 1881915338
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Gary Blake, Managing Member(817) 348-8841
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3000 Veterans Pkwy S
Moultrie, GA 31788-7762
Phone: (229) 890-3342
Fax: (229) 891-3355
Approximate (ZIP-level) locationGet directions
Mailing address
3000 Veterans Pkwy S
Moultrie, GA 31788-7762
Other names (DBA / former)
- Doing business as
- Park Regency of Moultrie
Registry dates
- Enumerated
- 2010-06-18
- Last updated
- 2010-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.