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Organization
COFFEE COUNTY NURSING HOME, LLC
Active
Organization
COFFEE COUNTY NURSING HOME, LLC
Active
Other names
Shady Acres
Organization subpart
No
Provider details
NPI number
Authorized official
KIM SHEFFIELD (VP OF FINANCIAL REPORTING)
(478) 621-2100
Entity
Organization
Contact information
Practice address
1310 GORDON ST W, DOUGLAS, GA 31533-3432
(912) 384-7811
(912) 384-7695
Mailing address
1310 GORDON ST W, DOUGLAS, GA 31533-3432
(912) 384-7811
(912) 384-7695
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
1-056-1784
GA
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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