Organization
CRESTWOOD NURSING CENTER INC
Active
Other names
Putnam Council on Aging Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HAGAN (PRESIDENT)
(770) 993-4000
Entity
Organization
Contact information
Practice address
501 S PALM AVE, PALATKA, FL 32177-4147
(386) 328-1472
(386) 325-1531
Mailing address
995 CANTON ST STE 100, ROSWELL, GA 30075-4240
(709) 934-0000
(386) 325-1531
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031227400
—
FL
Enumeration date
08/10/2005
Last updated
07/18/2019
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