# BROOKWOOD-MADISON COUNTY CONVALESCENT CENTER LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Madison Manor Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578579165
- **Authorized official:** MS. DEBRA A GIEZENTANNER (NURSING HOME ADMINISTRATOR)
- **Authorized official phone:** (828) 689-5200

## Contact information

- **Practice address:** 345 MANOR RD, MARS HILL, NC 28754-7606
- **Practice address phone:** (828) 689-5200
- **Practice address fax:** (828) 689-2729
- **Mailing address:** 345 MANOR RD, MARS HILL, NC 28754-7606
- **Mailing address phone:** (828) 689-5200
- **Mailing address fax:** (828) 689-2729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 11/21/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0387870001 | DMERC | NC |
| 05 | — | 3405206 | — | NC |
| 05 | — | 3406224 | — | NC |
| 01 | — | NH0290 | DFS LICENSE | NC |