Healthcare Provider Details

I. General information

NPI: 1518937515
Provider Name (Legal Business Name): SYL-VIEW HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 PINE ST BOX 538
SYLVANIA GA
30467-2035
US

IV. Provider business mailing address

411 PINE ST BOX 538
SYLVANIA GA
30467-2035
US

V. Phone/Fax

Practice location:
  • Phone: 912-564-2015
  • Fax: 912-564-9218
Mailing address:
  • Phone: 912-564-2015
  • Fax: 912-564-9218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1124998
License Number StateGA

VIII. Authorized Official

Name: MRS. TONI R. ELLISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 912-564-2015