NPI 1699837864

Georgia Department of Human Resources

Organisation Intellectual Disabilities Intermediate Care Facility Gracewood, GA

Practice location

Address: 100 Myrtle Blvd, Gracewood, GA 30812-1500
Phone: (706) 790-2030

Authorised official

Name: Gail C Jackson
Title: Regional Hospital Administrator
Phone: (706) 790-2030

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 21211622 (GA)

Other Intermediate Care Facility, Intellectual Disabilities providers in Georgia →

Registry record

NPI: 1699837864
Entity type: Organization
NPI issued: 14 Dec 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.