- Enrollment id
- O20111208000165
- Enrollment state
- GA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1770597304
- Multiple npi flag
- N
- Ccn
- 115621
- Associate id
- 1850379843
- Organization name
- COOK MANAGEMENT SERVICES INC
- Doing business as name
- BRYAN COUNTY HLTH & REHAB CTR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- BRYAN COUNTY HLTH & REHAB CTR
- Address line 1
- 127 CARTER ST
- City
- RICHMOND HILL
- State
- GA
- Zip code
- 313243753