Organization
PRUITTHEALTH - BROOKHAVEN, LLC
Active
Other names
PruittHealth - Brookhaven
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL L. PRUITT JR. (CHAIRMAN & CEO OF MGR)
(770) 279-6200
Entity
Organization
Contact information
Practice address
3535 ASHTON WOODS DR NE, ATLANTA, GA 30319-2201
(770) 451-0236
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
(706) 827-2048
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-044-1768
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140115A
—
GA
Enumeration date
05/26/2006
Last updated
07/24/2014
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