Provider Demographics
NPI:1316657323
Name:GENESIS HEALTHCARE GROUP OF ATLANTA
Entity type:Organization
Organization Name:GENESIS HEALTHCARE GROUP OF ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BELK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-664-5111
Mailing Address - Street 1:270 17TH ST NW UNIT 2908
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30363-1260
Mailing Address - Country:US
Mailing Address - Phone:404-664-5111
Mailing Address - Fax:
Practice Address - Street 1:1720 PEACHTREE ST NW STE 1010A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2449
Practice Address - Country:US
Practice Address - Phone:404-664-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty