Organization
MONTEZUMA HEALTH CARE CENTER LLC
Active
Other names
Montezuma Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA ANN MIMS (ADMINISTRATOR)
(229) 478-8168
Entity
Organization
Contact information
Practice address
506 SUMTER ST, MONTEZUMA, GA 31063-1734
(478) 472-8168
(478) 472-2373
Mailing address
PO BOX 639, MONTEZUMA, GA 31063-0639
(478) 472-8168
(478) 472-2373
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-094-1731
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000142062A
—
GA
01
—
51046295 002
BCBS
—
Enumeration date
07/01/2006
Last updated
08/19/2024
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