Provider Demographics
NPI:1770597304
Name:COOK MANAGEMENT SERVICES INC
Entity type:Organization
Organization Name:COOK MANAGEMENT SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-641-1919
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-0790
Mailing Address - Country:US
Mailing Address - Phone:912-756-6130
Mailing Address - Fax:912-756-6540
Practice Address - Street 1:127 CARTER ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3753
Practice Address - Country:US
Practice Address - Phone:912-756-6131
Practice Address - Fax:912-756-6540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-015-1678314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1-015-1678OtherNURSING HOME PERMIT
GA00715569AMedicaid
GA1-015-1678OtherNURSING HOME PERMIT