Organization
ADK THUNDERBOLT OPERATOR, LLC
Active
Other names
Tara at Thunderbolt Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL GROEBER (VICE PRESIDENT/MIS)
(937) 964-8974
Entity
Organization
Contact information
Practice address
3223 FALLIGANT AVE, THUNDERBOLT, GA 31404-5339
(912) 691-2512
(912) 353-9354
Mailing address
3223 FALLIGANT AVE, THUNDERBOLT, GA 31404-5339
(912) 691-2512
(912) 353-9354
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000254
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000727801A
—
GA
Enumeration date
10/18/2006
Last updated
01/29/2011
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