CHC - Cedar Valley Nursing & Rehab Ctr, LLC
Organization Active NPI Skilled Nursing Facility · Cedartown, GA
NPI 1093711277 · NPPES record last updated Mar 21, 2014
Key facts
- NPI
- 1093711277
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 11151752 (GA)
- Legal business name
- CHC - CEDAR VALLEY NURSING & REHAB CTR, LLC
- Practice address
- 225 S Philpot St
Cedartown, GA 30125-3021 - Phone
- (770) 748-4116
- Fax
- (770) 748-2932
- NPI assigned
- Jun 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Mitchell Starer
- Title
- Manager
- Phone
- (914) 390-4300
Corporate family (same tax ID) 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0681203 | Cedar Valley Nursing & Rehab Center | Certificate of waiver | Jun 21, 2027 |
National Provider Directory
- Tax ID family
- Cedar Valley Cypress LLC
Locations
225 S Philpot St
Cedartown, GA 30125
Phone (770) 748-4116
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 11151752 | GA | Yes |
Addresses
Primary practice location
225 S Philpot St
Cedartown, GA 30125-3021
Mailing address
225 S Philpot St
Cedartown, GA 30125-3021
Phone (770) 748-4116
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00142557A | Medicaid | GA |
Other names
- Cedar Valley Nursing & Rehabilitation Center
Other providers in Cedartown, GA
- Judith Lynn Cathcart
- Cedar Creek Pediatrics
- Cedar Valley Cypress LLC
- Cedartown Dentistry P.C.
- Cedartown Radiology Group
- Anugra Ashwinbhai Chhaya
- Jessica Miranda Chisenall
- Clinic of Divine Health
- Heather Cochran
- Jacob James Collier
All providers in Cedartown, GA · Skilled Nursing Facility in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.