Organization
GRADY MEMORIAL HOSPITAL CORPORATION
Active
Other names
Crestview Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CORA LEDARE BULLOCK (ADMINISTRATOR)
(404) 616-8110
Entity
Organization
Contact information
Practice address
2800 SPRINGDALE RD SW, ATLANTA, GA 30315-7802
(404) 616-8100
Mailing address
2800 SPRINGDALE RD SW, ATLANTA, GA 30315-7802
(404) 616-8100
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-060-1275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00273567A
—
GA
Enumeration date
09/16/2006
Last updated
01/21/2025
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