Organization
STEVENS PARK HEALTH AND REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LANE (ADMINISTRATOR)
(478) 737-0350
Entity
Organization
Contact information
Practice address
820 STEVENS CREEK RD, AUGUSTA, GA 30907-9251
(478) 621-2100
Mailing address
820 STEVENS CREEK RD, AUGUSTA, GA 30907-9251
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-121-1951
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003143404A
—
GA
Enumeration date
06/11/2009
Last updated
09/28/2023
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