Organization
LAUREL BAYE HEALTHCARE OF DECATUR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM TILLER (CFO)
(843) 216-6800
Entity
Organization
Contact information
Practice address
3200 PANTHERSVILLE RD, DECATUR, GA 30034-3831
(404) 212-3400
Mailing address
3200 PANTHERSVILLE RD, DECATUR, GA 30034-3831
(404) 212-3400
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
158528
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000252942A
—
GA
Enumeration date
10/07/2005
Last updated
06/24/2009
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