Organization
PROVIDENCE SNF OPERATOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE E WERTHEIM (MANAGER)
(813) 347-9888
Entity
Organization
Contact information
Practice address
1011 S GREEN ST, THOMASTON, GA 30286-4643
(706) 647-6693
(706) 648-9255
Mailing address
1011 S GREEN ST, THOMASTON, GA 30286-4643
(706) 647-6693
(706) 648-9255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
GA
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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