Organization
PRUITTHEALTH - BLUE RIDGE LLC
Active
Other names
PruittHealth Community Services - Blue Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL L. PRUITT JR. (CHAIRMAN AND CEO)
(770) 279-6200
Entity
Organization
Contact information
Practice address
74 OUIDA STREET, BLUE RIDGE, GA 30513
(706) 258-2819
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140973A
—
GA
Enumeration date
03/13/2007
Last updated
06/30/2014
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