Provider Demographics
NPI:1225701667
Name:BRIGHTMOOR NURSING CENTER, LLC
Entity Type:Organization
Organization Name:BRIGHTMOOR NURSING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:REESE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:678-972-1644
Mailing Address - Street 1:3247 NEWNAN RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-7114
Mailing Address - Country:US
Mailing Address - Phone:678-972-1644
Mailing Address - Fax:770-467-9932
Practice Address - Street 1:3235 NEWNAN RD
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-7114
Practice Address - Country:US
Practice Address - Phone:770-228-8599
Practice Address - Fax:770-228-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility