Provider Demographics
NPI:1730582966
Name:OCONEE COUNTY HEALTH & REHABILITATION LLC
Entity type:Organization
Organization Name:OCONEE COUNTY HEALTH & REHABILITATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-769-7738
Mailing Address - Street 1:3450 NEW HIGH SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621-1305
Mailing Address - Country:US
Mailing Address - Phone:706-769-7738
Mailing Address - Fax:706-769-5944
Practice Address - Street 1:3450 NEW HIGH SHOALS RD
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:GA
Practice Address - Zip Code:30621-1305
Practice Address - Country:US
Practice Address - Phone:706-769-7738
Practice Address - Fax:706-769-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-108-2053314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00212814AMedicaid
115279Medicare Oscar/Certification