Provider Demographics
NPI:1235171174
Name:TAYLOR COUNTY HEALTH CARE LLC
Entity Type:Organization
Organization Name:TAYLOR COUNTY HEALTH CARE LLC
Other - Org Name:TAYLOR COUNTY HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-862-2220
Mailing Address - Street 1:PO BOX 2400
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:GA
Mailing Address - Zip Code:31006-2400
Mailing Address - Country:US
Mailing Address - Phone:478-862-2220
Mailing Address - Fax:478-862-2626
Practice Address - Street 1:165 S BROAD ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:GA
Practice Address - Zip Code:31006-5526
Practice Address - Country:US
Practice Address - Phone:478-862-2220
Practice Address - Fax:478-862-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-133-1701314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00432924AMedicaid
51001248 001OtherBCBS
51001248 001OtherBCBS