Organization
EATONTON FACILITY DEVELOPMENT COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE W WEST (CFO)
(770) 907-2417
Entity
Organization
Contact information
Practice address
155 GREENSBORO RD, EATONTON, GA 31021
(770) 907-2417
Mailing address
34 UPPER RIVERDALE RD SE, SUITE 100, RIVERDALE, GA 30274-2635
(770) 907-7222
Taxonomy
Speciality
Code
Description
License number
State
315D00000X
Inpatient Hospice
Primary
007-0309-H
GA
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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