| NPI | 1871589580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE R. ERICKSON Administrator 770-703-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: GA NHA004005) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2020-08-22 |