# PRUITTHEALTH - BLUE RIDGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PruittHealth Community Services - Blue Ridge
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710010715
- **Authorized official:** NEIL L. PRUITT JR. (CHAIRMAN AND CEO)
- **Authorized official phone:** (770) 279-6200

## Contact information

- **Practice address:** 74 OUIDA STREET, BLUE RIDGE, GA 30513
- **Practice address phone:** (706) 258-2819
- **Mailing address:** 1626 JEURGENS CT, NORCROSS, GA 30093-2219
- **Mailing address phone:** (770) 279-6200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 06/30/2014