Healthcare Provider Details

I. General information

NPI: 1902160393
Provider Name (Legal Business Name): ABBEVILLE HEALTHCARE & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 MAIN ST E
ABBEVILLE GA
31001-4216
US

IV. Provider business mailing address

206 MAIN ST E
ABBEVILLE GA
31001-4216
US

V. Phone/Fax

Practice location:
  • Phone: 229-467-2515
  • Fax:
Mailing address:
  • Phone: 229-467-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBORAH JEAN JONES
Title or Position: MEMBER
Credential:
Phone: 423-877-2024