Provider Demographics
NPI:1588754782
Name:SAVANNAH VALLEY REHABILITATION
Entity type:Organization
Organization Name:SAVANNAH VALLEY REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-678-3344
Mailing Address - Street 1:121B GORDON ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30673-1601
Mailing Address - Country:US
Mailing Address - Phone:706-678-3344
Mailing Address - Fax:706-678-3366
Practice Address - Street 1:121B GORDON ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:GA
Practice Address - Zip Code:30673-1601
Practice Address - Country:US
Practice Address - Phone:706-678-3344
Practice Address - Fax:706-678-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00221603BMedicaid
GA00221603BMedicaid