Organization
GADECATUR SNF LLC
Active
Other names
East Lake Arbor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD PHILLIP STOLL (MBR)
(917) 836-0436
Entity
Organization
Contact information
Practice address
304 FIFTH AVE, DECATUR, GA 30030-4812
(404) 373-6231
Mailing address
78 BIRCHWOOD DR, HUNTINGTN STA, NY 11746-3922
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
01/19/2022
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