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Organization

UNIVERSITY EXTENDED CARE, INC

Active
Other names
KENTWOOD NURSING HOME
Organization subpart
No

Provider details

NPI number
Authorized official
NANCY G. POWELL (ADMINISTRATOR)
(706) 863-1188
Entity
Organization

Contact information

Practice address
1227 W WHEELER PKWY, AUGUSTA, GA 30909-1899
(706) 863-1188
(706) 863-2449
Mailing address
1227 W WHEELER PKWY, AUGUSTA, GA 30909-1899
(706) 863-1188
(706) 863-2449

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2006004129
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00143426A
GA
Enumeration date
04/21/2006
Last updated
12/23/2009
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