- Enrollment id
- O20061106000313
- Enrollment state
- GA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1437260056
- Multiple npi flag
- N
- Ccn
- 115717
- Associate id
- 0446257448
- Organization name
- RELIABLE HEALTH & REHAB AT LAKEWOOD, LLC
- Doing business as name
- RELIABLE HEALTH & REHAB AT LAKEWOOD
- Incorporation date
- 2006-08-02
- Incorporation state
- GA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- RELIABLE HEALTH & REHAB AT LAKEWOOD
- Affiliation entity name
- RELIABLE HEALTH CARE MANAGEMENT
- Affiliation entity id
- 728
- Address line 1
- 1980 ARROW ST SW
- City
- ATLANTA
- State
- GA
- Zip code
- 303105050