Organization
WESTBURY CONYERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENELOPE W GRIFFIN (CHIEF OPERATING OFFICER)
(770) 228-1228
Entity
Organization
Contact information
Practice address
1420 MILSTEAD RD NE, CONYERS, GA 30012-3823
(770) 483-3902
(770) 483-2342
Mailing address
1420 MILSTEAD RD NE, CONYERS, GA 30012-3823
(770) 483-3902
(770) 483-2342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
11221890
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000143503A
—
GA
01
—
5100710 001
BCBS
—
Enumeration date
06/20/2006
Last updated
07/31/2017
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