Organization
RICHMOND NURSING HOME INC
Active
Other names
West Lake Manor Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS W PENLEY SR. (CEO)
(706) 855-1773
Entity
Organization
Contact information
Practice address
820 STEVENS CREEK RD, AUGUSTA, GA 30907-9251
(706) 860-6622
(706) 860-6532
Mailing address
820 STEVENS CREEK RD, AUGUSTA, GA 30907-9251
(706) 860-6622
(706) 860-6532
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00213463A
—
GA
01
—
1062280001
DME
—
Enumeration date
07/29/2005
Last updated
08/22/2020
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