| Organization Name: | SOUTHERN HEALTH CORP OF ELLIJAY |
| NPI Number: | 1013248962 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBBIE ANN SELF (CFO) |
| Mailing Address: | 60 Old Highway 5 South Ellijay |
| State: | GA US |
| Postal Code: | 305405436 |
| Phone Number: | 7062764741 |
| Fax Number: | 7062764645 |
| NPI Enumeration Date: | 01/15/2010 |
| NPI Last Update Date: | 01/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 061435 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |