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General NPI Number Information
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NPI Number | 1851757744
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Entity Type | Organization
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Legal Business Name | CV SNF LLC
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 402 BAY ST E
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City | PINEVIEW
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State | GA
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Zip | 31071-3430
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Country | US
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Telephone | 229-624-2437
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Fax | 229-624-2715
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Provider Business Mailing Address
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Address Line | 402 BAY ST E
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City | PINEVIEW
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State | GA
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Zip | 31071-3430
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Country | US
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Telephone | 229-624-2437
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Fax | 229-624-2715
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Authorized Official
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Title or Position | MANAGER
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Name | BRUCE E WERTHEIM
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Credential |
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Telephone | 917-919-7204
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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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