Basic Information
| Provider Information | |||||||||
| NPI: | 1386388189 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BRIARWOOD HEALTH CENTER BY HARBORVIEW, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3888 LAVISTA RD | ||||||||
| Address2: | |||||||||
| City: | TUCKER | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300845142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709385740 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3888 LAVISTA RD | ||||||||
| Address2: | |||||||||
| City: | TUCKER | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300845142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709385740 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2022 | ||||||||
| LastUpdateDate: | 04/27/2022 | ||||||||
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| AuthorizedOfficialLastName: | LEIBOWITZ | ||||||||
| AuthorizedOfficialFirstName: | CHAIM | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9178401661 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.