Provider Demographics
NPI:1164849774
Name:HART COUNTY HEALTH & REHABILITATION, LLC
Entity Type:Organization
Organization Name:HART COUNTY HEALTH & REHABILITATION, LLC
Other - Org Name:HARTWELL HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-856-6982
Mailing Address - Street 1:94 CADE ST
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-1814
Mailing Address - Country:US
Mailing Address - Phone:706-856-6982
Mailing Address - Fax:706-856-6989
Practice Address - Street 1:94 CADE ST
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-1814
Practice Address - Country:US
Practice Address - Phone:706-856-6982
Practice Address - Fax:706-856-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-073-2038314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000141413AMedicaid
GA115435Medicare Oscar/Certification