Organization
ROBERTA OPERATOR LLC
Active
Other names
Roberta Health and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID THORNTON (ADMINISTRATOR)
(478) 836-3101
Entity
Organization
Contact information
Practice address
420 MYRTLE DR, ROBERTA, GA 31078-9752
(478) 836-3101
(478) 836-2700
Mailing address
420 MYRTLE DR, ROBERTA, GA 31078-9752
(478) 836-3101
(478) 836-2700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-039-1080
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000142777A
—
GA
Enumeration date
03/28/2008
Last updated
01/23/2015
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