Adk Bonterra Parkview, LLC

Organization Active NPI Skilled Nursing Facility · Atlanta, GA

NPI 1710068564 · NPPES record last updated Apr 24, 2014

Key facts

NPI
1710068564
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
005657LGB (GA)
Legal business name
ADK BONTERRA PARKVIEW, LLC
Practice address
460 Auburn Ave NE
Atlanta, GA 30312-1504
Phone
(404) 523-1613
Fax
(404) 681-4536
NPI assigned
Oct 18, 2006
Organization subpart
No

Authorized official

Name
David Rubenstein
Title
Coo
Phone
(678) 869-5116

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
460 Auburn Avenue LP (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 005657LGB GA Yes

Addresses

Primary practice location

460 Auburn Ave NE
Atlanta, GA 30312-1504

Mailing address

460 Auburn Ave NE
Atlanta, GA 30312-1504
Phone (404) 523-1613

Other identifiers

IdentifierTypeStateIssuer
000141831AMedicaidGA

Other names

  • Legacy Nursing & Rehabilitation Center Doing business as

Other providers in Atlanta, GA

All providers in Atlanta, GA · Skilled Nursing Facility in Georgia

Sources for this page

Verify at the official NPI Registry.