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Contact Information

BRENTWOOD NURSING LLC
280 MYRTLE DRIVE
ROBERTA, GA31078
 Phone: 478-836-3101
 Fax: 478-836-2700
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for BRENTWOOD NURSING LLC

NPI # 1083776520
LBN Legal business name BRENTWOOD NURSING LLC
Authorized official TYGH BROGDON - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/14/2006
Last updated 09/29/2008 - About 18 years ago
Identifiers
GA License # 1-039-1747
GA Medicaid 00142777A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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