Provider Demographics
NPI:1407123557
Name:WOODLANDS HEALTHCARE & REHAB LLC
Entity Type:Organization
Organization Name:WOODLANDS HEALTHCARE & REHAB LLC
Other - Org Name:WOODLANDS HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-877-2024
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:GA
Mailing Address - Zip Code:31320-0270
Mailing Address - Country:US
Mailing Address - Phone:912-884-3361
Mailing Address - Fax:912-884-5730
Practice Address - Street 1:625 COASTAL HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:GA
Practice Address - Zip Code:31320
Practice Address - Country:US
Practice Address - Phone:912-884-3361
Practice Address - Fax:912-884-5730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000141985AMedicaid
GA000141985AMedicaid