Organization
BULLOCH COUNTY LTC LLC
Active
Other names
Eagle Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR MCCOY (ADMINISTRATOR)
(912) 764-4575
Entity
Organization
Contact information
Practice address
405 S COLLEGE ST, STATESBORO, GA 30458-5409
(912) 764-4575
(912) 764-3916
Mailing address
PO BOX 746, STATESBORO, GA 30459-0746
(912) 764-4575
(912) 764-3916
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-016-1898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000143151A
—
GA
Enumeration date
06/25/2006
Last updated
05/16/2025
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