Healthcare Provider Details

I. General information

NPI: 1356687560
Provider Name (Legal Business Name): JEFFERSONVILLE HEALTHCARE & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 12/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 SPRING VALLEY RD
JEFFERSONVILLE GA
31044-3917
US

IV. Provider business mailing address

113 SPRING VALLEY RD
JEFFERSONVILLE GA
31044-3917
US

V. Phone/Fax

Practice location:
  • Phone: 478-945-2520
  • Fax: 478-945-2525
Mailing address:
  • Phone: 478-945-2520
  • Fax: 478-945-2525

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: DEBBIE JONES
Title or Position: COO
Credential:
Phone: 423-648-6750