Organization
CHRISTIAN CITY CONVALESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE R. ERICKSON (ADMINISTRATOR)
(770) 703-2611
Entity
Organization
Contact information
Practice address
7300 LESTER RD, UNION CITY, GA 30291-2328
(770) 964-3301
Mailing address
7300 LESTER RD, UNION CITY, GA 30291-2328
(770) 964-3301
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NHA004005
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71-00122
EVERCARE/UNITED HEALTH CA
GA
Enumeration date
09/27/2005
Last updated
08/22/2020
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