Brentwood Terrace Health Center, LLC
Organization Active NPI Skilled Nursing Facility · Waynesboro, GA
NPI 1477595403 · NPPES record last updated Feb 17, 2010
Key facts
- NPI
- 1477595403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1-017-1711 (GA)
- Legal business name
- BRENTWOOD TERRACE HEALTH CENTER, LLC
- Practice address
- 115 Brentwood Dr
Waynesboro, GA 30830-4519 - Phone
- (706) 554-4425
- Fax
- (706) 554-6163
- NPI assigned
- Jun 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Tina Lane
- Title
- Administrator
- Phone
- (706) 554-4425
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-017-1711 | GA | Yes |
Addresses
Primary practice location
115 Brentwood Dr
Waynesboro, GA 30830-4519
Mailing address
PO Box 907
Waynesboro, GA 30830-0907
Phone (706) 554-4425
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00140071A | Medicaid | GA | |
| 51001331 001 | Other | BCBS |
Other names
- Brentwood Health and Rehabilitation
Other providers in Waynesboro, GA
- Sarah Boothe
- Megan Bostic
- Ashley J Boynton
- Savanna Bradham
- Brentwood Health Center LLC
- Billy Clifford Brinson Jr.
- Darcy Brogan
- Frances Gilbreth Brown
- Kendall Brown
- Debra S Burch
All providers in Waynesboro, 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 Feb 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.