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General NPI Number Information
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NPI Number | 1891879813
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Entity Type | Organization
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Legal Business Name | A.G. RHODES EXTENDACARE, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3715 NORTHSIDE PKWY NW BUILDING 400, SUITE 305
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City | ATLANTA
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State | GA
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Zip | 30327-2806
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Country | US
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Telephone | 404-949-3830
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Fax | 404-949-3831
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Provider Business Mailing Address
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Address Line | 3715 NORTHSIDE PKWY NW BUILDING 400, SUITE 305
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City | ATLANTA
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State | GA
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Zip | 30327-2806
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Country | US
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Telephone | 404-949-3830
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Fax | 404-949-3831
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. RUSSELL JOSEPH WILLIAMS
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Credential |
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Telephone | 404-949-3830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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Taxonomy #5
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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Taxonomy #6
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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Taxonomy #7
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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