Healthcare Provider Details

I. General information

NPI: 1154369635
Provider Name (Legal Business Name): THE WILLIAM BREMAN JEWISH HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 HOWELL MILL RD NW
ATLANTA GA
30327-2108
US

IV. Provider business mailing address

3150 HOWELL MILL RD NW
ATLANTA GA
30327-2108
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-2324
  • Fax: 404-351-6698
Mailing address:
  • Phone: 404-351-2324
  • Fax: 404-351-6698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. NEELAM RAHATEKAR
Title or Position: CFO-COO
Credential:
Phone: 404-351-1934