Organization
FORT VALLEY OPERATOR LLC
Active
Other names
Fort Valley Health and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE DELKER (CFO)
(813) 321-1239
Entity
Organization
Contact information
Practice address
604 BLUEBIRD BLVD, FORT VALLEY, GA 31030-5081
(478) 825-2031
(478) 825-2041
Mailing address
604 BLUEBIRD BLVD, FORT VALLEY, GA 31030-5081
(478) 825-2031
(478) 825-2041
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-111-1073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000141028A
—
GA
Enumeration date
03/27/2008
Last updated
01/17/2022
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