Provider Demographics
NPI:1245578178
Name:AZ OPERATOR LLC
Entity Type:Organization
Organization Name:AZ OPERATOR LLC
Other - Org Name:HEART OF GEORGIA NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:OVITS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-694-6055
Mailing Address - Street 1:5014 16TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:815 LEGION DR
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6782
Practice Address - Country:US
Practice Address - Phone:478-231-6866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AZ TRUST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility