Ga Department of Human Resources

NPI #1639166234 in Gracewood, Georgia

Provider Information

NPI Number
1639166234
Entity Type
Organization
Organization Name
Ga Department of Human Resources
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Sep 29, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
100 MYRTLE BLVD
State
Georgia
ZIP Code
30812-1500
Phone
(706) 790-2042

Authorized Official

Name
DR. GAIL C JACKSON, M.D.
Title
REGIONAL HOSPITAL ADMINISTRATOR
Phone
(706) 790-2030

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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