Coffee County Nursing Home, LLC
Organization Active NPI Adult Day Care Clinic/Center · Douglas, GA
NPI 1730218702 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1730218702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Day Care Clinic/Center 261QA0600X
- License
- 1-056-1784 (GA)
- Legal business name
- COFFEE COUNTY NURSING HOME, LLC
- Practice address
- 1310 Gordon St W
Douglas, GA 31533-3432 - Phone
- (912) 384-7811
- Fax
- (912) 384-7695
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Kim Sheffield
- Title
- VP of Financial Reporting
- Phone
- (478) 621-2100
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Coffee County Nursing Home LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 1-056-1784 | GA | Yes |
Addresses
Primary practice location
1310 Gordon St W
Douglas, GA 31533-3432
Mailing address
1310 Gordon St W
Douglas, GA 31533-3432
Phone (912) 384-7811
Other names
- Shady Acres
Other providers in Douglas, GA
- Coffee County Board of Health
- Coffee County Board of Health
- Coffee County Center for Digestive Diseases LLC
- Coffee County Hospitalist Physicians, LLC
- Coffee County Nursing Home LLC
- Coffee County Nursing Home, LLC
- Coffee County Pediatrics PC
- Coffee County Sleep Services, LLC
- Coffee CS Comp
- Coffee Emergency Group LLC
All providers in Douglas, GA · Adult Day Care Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.