Providence Snf Operator LLC

NPI #1114448271 in Thomaston, Georgia

Provider Information

NPI Number
1114448271
Entity Type
Organization
Organization Name
Providence Snf Operator LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jun 29, 2017
Last Updated
Jul 21, 2022

Practice Location

Address
1011 S GREEN ST
State
Georgia
ZIP Code
30286-4643
Phone
(706) 647-6693

Authorized Official

Name
BRUCE E WERTHEIM
Title
MANAGER
Phone
(813) 347-9888

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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Provider Name
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