Organization
GOLDEN AGE OAK VIEW HOME LLC
Active
Other names
Oak View
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA JEFFERSON (ADMINISTRATOR)
(706) 582-2117
Entity
Organization
Contact information
Practice address
119 OAK VIEW ST, WAVERLY HALL, GA 31831-0459
(706) 582-2117
(706) 582-2116
Mailing address
PO BOX 459, WAVERLY HALL, GA 31831-0459
(706) 582-2117
(706) 582-2116
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-072-1703
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00142249A
—
GA
01
—
51003285 001
BCBS
—
Enumeration date
06/12/2006
Last updated
09/28/2023
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