Organization
DOUGLASVILLE NURSING AND REHABILITATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORBERT A BENNETT (CO CHIEF EXECUTIVE OFFICER)
(716) 662-4955
Entity
Organization
Contact information
Practice address
4028 HIGHWAY 5, DOUGLASVILLE, GA 30135-3530
(770) 942-7111
(770) 489-1268
Mailing address
P O BOX 0428, ORCHARD PARK, NY 14127
(716) 662-4955
(716) 667-9230
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-048-1741
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00141083A
—
GA
Enumeration date
01/06/2006
Last updated
04/24/2026
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