Organization
CPLACE DECATUR SNF LLC
Active
Other names
East Lake Arbor
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR M MARCOS (CFO)
(917) 209-1431
Entity
Organization
Contact information
Practice address
304 FIFTH AVE, DECATUR, GA 30030-4812
(404) 373-6231
Mailing address
24641 US HIGHWAY 19 N, CLEARWATER, FL 33763-5007
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-044-1435
GA
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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