Organization
BRENTWOOD TERRACE HEALTH CENTER, LLC
Active
Other names
Brentwood Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LANE (ADMINISTRATOR)
(706) 554-4425
Entity
Organization
Contact information
Practice address
115 BRENTWOOD DR, WAYNESBORO, GA 30830-4519
(706) 554-4425
(706) 554-6163
Mailing address
PO BOX 907, WAYNESBORO, GA 30830-0907
(706) 554-4425
(706) 554-6163
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-017-1711
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140071A
—
GA
01
—
51001331 001
BCBS
—
Enumeration date
06/12/2006
Last updated
02/17/2010
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