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NPI Code Detail

MEDICARE: THE CROSSROADS OF FLOWERY BRANCH OF JOURNEY LLC

MEDICARE: THE CROSSROADS OF FLOWERY BRANCH OF JOURNEY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1962238162
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CROSSROADS OF FLOWERY BRANCH OF JOURNEY LLC
Provider Business Mailing Address
First Line : 4595 CANTRELL RD
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3304
Country : US
Telephone Number : 770-967-2070
Fax Number : 770-200-4210
Provider Business Practice Location Address
First Line : 4595 CANTRELL RD
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3304
Country : US
Telephone Number : 770-967-2070
Fax Number : 770-200-4210
Authorized Official
Title or Position : OFFICER
Name : BERNARD J MCGUINNESS III
Credential :
Telephone Number : 463-278-0868
Provider Enumeration Date : 09/12/2024
Last Update Date : 09/12/2024

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Directions to “THE CROSSROADS OF FLOWERY BRANCH OF JOURNEY LLC ” Practice Location

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