Organization
GWENDOLYN WILKES RAINBOW CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLORIA A RODGERS DO (COORDINATOR)
(706) 320-9012
Entity
Organization
Contact information
Practice address
2201 BUENA VISTA RD, COLUMBUS, GA 31906-3121
(706) 320-9012
(706) 320-9021
Mailing address
2201 BUENA VISTA RD, COLUMBUS, GA 31906-3121
(706) 320-9012
(706) 320-9021
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00070132B
—
GA
Enumeration date
04/17/2007
Last updated
07/21/2008
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