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General NPI Number Information
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NPI Number | 1154158384
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Entity Type | Organization
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Legal Business Name | PARKSIDE AT BUDD TERRACE OPERATING COMPANY LLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 1833 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-4021
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Country | US
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Telephone | 404-728-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 1833 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-4021
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Country | US
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Telephone | 404-728-6500
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MICHAEL V FEIST
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Credential |
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Telephone | 631-525-6693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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