Organization
HEALTHCARE AT COLLEGE PARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E WINGET JR. (SECRETARY)
(478) 974-0006
Entity
Organization
Contact information
Practice address
1765 TEMPLE AVE, COLLEGE PARK, GA 30337-2736
(404) 767-8609
(404) 766-2957
Mailing address
1765 TEMPLE AVE, COLLEGE PARK, GA 30337-2736
(404) 767-8609
(404) 766-2957
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000140654A
—
GA
Enumeration date
03/27/2015
Last updated
03/27/2015
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