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General NPI Number Information
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NPI Number | 1710035969
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Entity Type | Organization
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Legal Business Name | HEALTHCARE OF BERRIEN COUNTY, INC.
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Dates
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Enumeration Date | 01/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 405 LAUREL ST
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City | NASHVILLE
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State | GA
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Zip | 31639-2571
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Country | US
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Telephone | 229-543-7318
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Fax | 229-543-1724
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Provider Business Mailing Address
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Address Line | 405 LAUREL ST
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City | NASHVILLE
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State | GA
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Zip | 31639-2571
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Country | US
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Telephone | 229-543-7318
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Fax | 229-543-1724
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | DEMARIS HUGHES
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Credential |
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Telephone | 229-543-7309
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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 | 10101119
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License Number State | GA
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