# SOUTHERN CRESCENT REHABILITATION AND RETIREMENT COMMUNITY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Crescent TBI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043334782
- **Authorized official:** MR. ABID MALIK (SECRETARY)
- **Authorized official phone:** (678) 565-7710

## Contact information

- **Practice address:** 2125 HIGHWAY 42 N, MCDONOUGH, GA 30253-4733
- **Practice address phone:** (678) 565-7710
- **Practice address fax:** (678) 565-9723
- **Mailing address:** 2125 HWY 42N, MCDONOUGH, GA 30253-4733
- **Mailing address phone:** (678) 565-7710
- **Mailing address fax:** (678) 565-9723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 08/07/2014