| NPI | 1396788428 |
|---|---|
| Doing Business As | NORTHSIDE GWINNETT EXTENDED CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | JORGE HERNANDEZ VP Admin; Cco 404-851-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: GA 067-460) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-09-18 |