- Enrollment id
- O20250611003377
- Enrollment state
- GA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1528894714
- Multiple npi flag
- N
- Ccn
- 115482
- Associate id
- 3577073113
- Organization name
- THE CROSSINGS AT EAST LAKE OF JOURNEY LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CROSSINGS AT EAST LAKE OF JOURNEY LLC, THE
- Affiliation entity name
- JOURNEY HEALTHCARE
- Affiliation entity id
- 766
- Address line 1
- 304 5TH AVE
- City
- DECATUR
- State
- GA
- Zip code
- 300304812