Organization
CANTON CONVALESCENT CENTER INC
Active
Other names
Canton Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT F. SHAW (ADMINISTRATOR)
(770) 479-8791
Entity
Organization
Contact information
Practice address
321 HOSPITAL RD, CANTON, GA 30114-2411
(770) 479-8791
(770) 479-5681
Mailing address
321 HOSPITAL RD, CANTON, GA 30114-2411
(770) 479-8791
(770) 479-5681
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-028-1183
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140511A
—
GA
Enumeration date
10/26/2005
Last updated
11/29/2011
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