Organization
PROFESSIONAL RESOURCES MANAGEMENT OF RABUN LLC
Active
Other names
MOUNTAIN LAKES MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY HALL (CEO)
(706) 782-0400
Entity
Organization
Contact information
Practice address
162 LEGACY PT, CLAYTON, GA 30525-5354
(706) 782-3100
Mailing address
162 LEGACY PT, CLAYTON, GA 30525-5354
(706) 782-3100
(706) 782-6897
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
119621
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001559S
—
GA
Enumeration date
02/28/2007
Last updated
06/23/2025
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