Organization
PORTER FIELD HEALTH & REHAB CENTER LLC
Active
Other names
Hartley Woods Health & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
TYGH BROGDON (MANAGER)
(770) 650-8773
Entity
Organization
Contact information
Practice address
3051 WHITESIDE RD, MACON, GA 31216-6209
(478) 788-1421
(478) 781-0987
Mailing address
3051 WHITESIDE RD, MACON, GA 31216-6209
(478) 788-1421
(478) 781-0987
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
10111615
GA
314000000X
Skilled Nursing Facility
Primary
10111916
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00222582A
—
GA
Enumeration date
12/13/2006
Last updated
03/31/2008
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