Healthcare Provider Details

I. General information

NPI: 1922008903
Provider Name (Legal Business Name): FRIENDSHIP HEALTH & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FRIENDSHIP RD
CLEVELAND GA
30528-5724
US

IV. Provider business mailing address

161 FRIENDSHIP RD
CLEVELAND GA
30528-5724
US

V. Phone/Fax

Practice location:
  • Phone: 706-865-3131
  • Fax: 706-865-6654
Mailing address:
  • Phone: 706-865-3131
  • Fax: 706-865-6654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1-154-1806
License Number StateGA

VIII. Authorized Official

Name: MR. ANDREW JACKSON MORRIS III
Title or Position: MANAGING MEMBER
Credential:
Phone: 706-378-0940