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Organization
TREUTLEN COUNTY NURSING HOME LLC
Active
Organization
TREUTLEN COUNTY NURSING HOME LLC
Active
Other names
Treutlen Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNIE BROOKS (ADMINISTRATOR)
(912) 529-4418
Entity
Organization
Contact information
Practice address
5590 N 3RD ST, SOPERTON, GA 30457-2007
(912) 529-4418
(912) 529-3322
Mailing address
5590 N 3RD ST, SOPERTON, GA 30457-2007
(912) 529-4418
(912) 529-3322
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
140-02-001-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000404027A
—
GA
Enumeration date
05/24/2011
Last updated
05/24/2011
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