Provider Demographics
NPI:1487620498
Name:GRANDVIEW HEALTH CARE CENTER, INC
Entity type:Organization
Organization Name:GRANDVIEW HEALTH CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KARSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-939-8720
Mailing Address - Street 1:618 GENNETT DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-1143
Mailing Address - Country:US
Mailing Address - Phone:706-682-6323
Mailing Address - Fax:706-692-3279
Practice Address - Street 1:618 GENNETT DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-1143
Practice Address - Country:US
Practice Address - Phone:706-692-6323
Practice Address - Fax:706-692-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11121215314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00141226AMedicaid
GA115502Medicare ID - Type Unspecified