Organization
GA DEPARTMENT OF HUMAN RESOURCES
Active
Other names
ECRH Skilled Nursing Home No 9
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL C JACKSON M.D. (REGIONAL HOSPITAL ADMINISTRATOR)
(706) 790-2030
Entity
Organization
Contact information
Practice address
100 MYRTLE BLVD, GRACEWOOD, GA 30812-1500
(706) 790-2042
(706) 790-2476
Mailing address
100 MYRTLE BLVD, GRACEWOOD, GA 30812-1500
(706) 790-2042
(706) 790-2476
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1121694
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140709A
—
GA
Enumeration date
09/29/2005
Last updated
08/22/2020
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