Healthcare Provider Details

I. General information

NPI: 1407765613
Provider Name (Legal Business Name): HADARA HEALTH & WELLNESS OF ELBERTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 DR GEORGE WARD RD
ELBERTON GA
30635-5971
US

IV. Provider business mailing address

2117 DR GEORGE WARD RD
ELBERTON GA
30635-5971
US

V. Phone/Fax

Practice location:
  • Phone: 706-283-3335
  • Fax: 706-213-6443
Mailing address:
  • Phone: 706-283-3335
  • Fax: 706-213-6443

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: CHAIM N HERTZEL
Title or Position: MANAGER
Credential:
Phone: 901-930-6124