Sas - Moran Lake, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAS - MORAN LAKE, INC.

Doing business as

Evergreen Health & Rehablitation Center

Practice address

139 Moran Lake Rd NE
Rome, GA 30161-7767

Phone

(770) 736-3028

NPI assigned

Nov 13, 2007

Last updated

Nov 13, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Karen D Forrister

Title

VC/Coo

Phone

(770) 736-3028

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Health & Rehablitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1598945065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 FIVE FORKS TRICKUM RD SW",
            "address_2": "SUITE 202",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471890",
            "telephone_number": "770-736-3028",
            "fax_number": "770-736-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 MORAN LAKE RD NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301617767",
            "telephone_number": "770-736-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAS - MORAN LAKE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "FORRISTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VC/COO",
        "authorized_official_telephone_number": "770-736-3028",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Health & Rehablitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arianna Nichole Sunshine Sanders
• Norma A Sandoval
• Natasha Amanda Sands, MD
• James Joseph Santoro, MD
• Lisa Sapp
• Sas - Mount Berry, Inc. (Summit Health & Rehabilitation Center)
• David Wyatt Saunders, MD
• Rebecca P Saye
• Deborah Ashley Scarborough, PA-C
• Caron Erica Schabort, OTR/L

• Skilled Nursing Facility in Rome, GA
• Providers in Rome, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.