# BULLOCH COUNTY LTC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eagle Health & Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669509865
- **Authorized official:** KIM SHEFFIELD (VP OF FINANCIAL REPORTING)
- **Authorized official phone:** (478) 621-2100

## Contact information

- **Practice address:** 405 S COLLEGE ST, STATESBORO, GA 30458-5409
- **Practice address phone:** (912) 764-4575
- **Practice address fax:** (912) 764-3916
- **Mailing address:** PO BOX 746, STATESBORO, GA 30459-0746
- **Mailing address phone:** (912) 764-4575
- **Mailing address fax:** (912) 764-3916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385H00000X | Respite Care | 1-016-1802 | GA | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 08/22/2020