Provider Demographics
NPI:1891879813
Name:A.G. RHODES EXTENDACARE, INC.
Entity Type:Organization
Organization Name:A.G. RHODES EXTENDACARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-949-3830
Mailing Address - Street 1:3715 NORTHSIDE PKWY NW
Mailing Address - Street 2:BUILDING 400, SUITE 305
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2806
Mailing Address - Country:US
Mailing Address - Phone:404-949-3830
Mailing Address - Fax:404-949-3831
Practice Address - Street 1:3715 NORTHSIDE PKWY NW
Practice Address - Street 2:BUILDING 400, SUITE 305
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2806
Practice Address - Country:US
Practice Address - Phone:404-949-3830
Practice Address - Fax:404-949-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251G00000XAgenciesHospice Care, Community Based
Not Answered251V00000XAgenciesVoluntary or Charitable
Not Answered261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Not Answered261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Not Answered315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)