Autumn Breeze Healthcare Center

LBN: Mt. Kenn Nursing, Llc
Autumn Breeze Healthcare Center is an health care organization with primary practice located at 1480 Sandtown Road , Marietta GA 30008-3821. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Mt. Kenn Nursing, Llc can be contacted via phone (770) 442-1755, or through Gentry, Boyd P via phone (937) 964-8974.

Contact Information

Primary practice address
1480 Sandtown Road Marietta GA 30008-3821
Phone: (770) 442-1755
Fax: (770) 442-8784
Website:
Map and Directions
Authorized official contact:
Name: Gentry, Boyd P
Phone: (937) 964-8974

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 05-47025 Georgia
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 1-033-1982 Georgia

Profile Details

NPI number 1053366336
LBN Legal business name Mt. Kenn Nursing, Llc
DBA Doing business as Autumn Breeze Healthcare Center
Authorized official Gentry, Boyd P
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2006
Last updated Jul 25th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053366336 NPPES
Georgia MEDICAID 00140159A

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