Organization Name: | CKCG HEALTHCARE SERVICES,INC |
NPI Number: | 1083796106 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAMUEL OKWUDILI OBUROTA (ADMINISTRATOR) |
Mailing Address: | 5995 Oakbrook Pkwy Suite -b Norcross |
State: | GA US |
Postal Code: | 30093 |
Phone Number: | 7702099998 |
Fax Number: | 7707299861 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 09/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3140N1450X |
License Number: | 060-R-0111 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Skilled Nursing Facility |
Taxonomy Specialization: | Nursing Care, Pediatric |
Taxonomy Definition: | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |