Organization
PINE LEAF INVESTMENT INC.
Active
Other names
McRae Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
TERRELL BUFORD COOK (COO)
(229) 868-7406
Entity
Organization
Contact information
Practice address
160 S FIRST AVE, MC RAE, GA 31055-3334
(229) 868-6473
(229) 868-2981
Mailing address
PO BOX 179, MC RAE, GA 31055-0179
(229) 868-6473
(229) 868-2981
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-134-1797
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000141853A
—
GA
Enumeration date
07/28/2006
Last updated
05/19/2013
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