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Organization

PINE LEAF INVESTMENT INC.

Active
Other names
Madison Health and Rehab
Organization subpart
No

Provider details

NPI number
Authorized official
TERRELL BUFORD COOK (COO)
(229) 868-7406
Entity
Organization

Contact information

Practice address
2036 S MAIN ST, MADISON, GA 30650-2054
(706) 342-3200
(706) 342-0028
Mailing address
2036 S MAIN ST, MADISON, GA 30650-2054
(706) 342-3200
(706) 342-0028

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-104-1639
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000083278A
GA
Enumeration date
07/28/2006
Last updated
05/19/2013
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