Organization
MOLENA EXTENDED CARE, LLC
Active
Other names
Molena Health & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISA D WINGET (MANAGER)
(478) 974-0006
Entity
Organization
Contact information
Practice address
185 HILL ST, MOLENA, GA 30258-3115
(770) 884-5138
(770) 884-5484
Mailing address
185 HILL ST, MOLENA, GA 30258-3115
(770) 884-5138
(770) 884-5484
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000142029A
—
GA
Enumeration date
09/07/2011
Last updated
10/11/2011
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