Organization
BETHEL GARDENS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LAVENDER SHELLEY (OWNER)
77094336290
Entity
Organization
Contact information
Practice address
3805 JACKSON WAY, POWDER SPRINGS, GA 30127-2239
(770) 943-3620
(770) 943-3691
Mailing address
3805 JACKSON WAY EXTENTION, POWDER SPRINGS, GA 30127-0710
(770) 943-3620
(770) 943-3691
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
033030181
GA
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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