Organization
CARROLLTON MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVELYN THOMPSON (ADMINISTRATOR)
(770) 834-1737
Entity
Organization
Contact information
Practice address
2455 OAK GROVE CHURCH RD, CARROLLTON, GA 30117-9513
(770) 834-1737
(770) 836-1223
Mailing address
PO BOX 2398, CARROLLTON, GA 30112-0044
(770) 834-1737
(770) 836-1223
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-022-1170
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140852A
—
GA
Enumeration date
06/15/2005
Last updated
08/22/2020
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