Healthcare Provider Details

I. General information

NPI: 1235171174
Provider Name (Legal Business Name): TAYLOR COUNTY HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 S BROAD ST
BUTLER GA
31006-5526
US

IV. Provider business mailing address

PO BOX 2400
BUTLER GA
31006-2400
US

V. Phone/Fax

Practice location:
  • Phone: 478-862-2220
  • Fax: 478-862-2626
Mailing address:
  • Phone: 478-862-2220
  • Fax: 478-862-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1-133-1701
License Number StateGA

VIII. Authorized Official

Name: LARALEE DANFORTH
Title or Position: ADMINISTRATOR
Credential:
Phone: 478-862-2220