FORUM GROUP AT WILDWOOD PARK NURSING & REHABILITATION CENTER, LLC (NPI# 1801978499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801978499 |
| Entity Type | Organization |
| Organization Name | FORUM GROUP AT WILDWOOD PARK NURSING & REHABILITATION CENTER, LLC |
| Practice Address |
2611 Wildwood Dr Brunswick GA 31520-4250 |
| Mailing Address |
1700 Water Pl Se Suite 206 Atlanta GA 30339-2006 |
| Practice Telephone | 9122641434 |
| Practice Fax Number | 9124669604 |
| Mailing Telephone | 6782132700 |
| Mailing Fax Number | 6782132705 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GEORGE DALYN HOUSER (MANAGER) |
| Authorized Official Telephone | 7062918600 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 10631819 | GA | Nursing & Custodial Care Facilities |
| Street Address |
2611 WILDWOOD DR |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31520-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619135464 | Southeast Georgia Health System, Inc. | Skilled Nursing Facility | 2611 Wildwood Dr, Brunswick, GA 31520-4250 | 2008-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1063961845 | Irene Limon | Licensed Practical Nurse | 2009 Ellis Street, Brunswick, GA 31520 | 2016-09-22 |
| 1770936551 | Elaine Latimer-tandy | Counselor | 1801 Gloucester St Ste E, Brunswick, GA 31520 | 2016-07-18 |
| 1710336326 | Giva, Inc. | Home Health | 8 St Andrews Court, Brunswick, GA 31520 | 2016-06-06 |
| 1447618525 | Parmelee Eye Care LLC | Point of Service | 1909 Gloucester St, Brunswick, GA 31520 | 2016-02-04 |
| 1578947800 | Holly Diskin Kinsey | Nurse Practitioner | 3400 Parkwood Drive, Brunswick, GA 31520 | 2015-07-16 |
| 1679976419 | Miriam Hosey | Registered Nurse | 2747 Fourth Street, Glynn County Health Dept., Brunswick, GA 31520 | 2014-10-08 |
| 1558779348 | Tracey Renee Price | Internal Medicine | 3025 Shrine Rd Ste 290, Brunswick, GA 31520 | 2014-07-24 |
| 1770901951 | Candace Shepherd | Social Worker | 707 F Street, Brunswick, GA 31520 | 2014-04-03 |
| 1699193599 | Enrique Martinez, M.d., P.C. | Internal Medicine | 3114 A Shrine Road, Brunswick, GA 31520 | 2014-03-29 |
| Find all providers in zip 31520 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548780802 | Brunswick Health & Rehabilitation Center, Inc. | Skilled Nursing Facility | 4355 Laurel Rd, Brunswick, OH 44212 | 2017-06-27 |
| 1396726501 | Mid Coast Geriatric Services Corp | Skilled Nursing Facility | 58 Baribeau Dr, Brunswick, ME 04011-3218 | 2005-11-07 |
| 1265422331 | Lightning Creek Investment Group,inc | Skilled Nursing Facility | 721 W Harrison St, Brunswick, MO 65236 | 2005-10-28 |
| 1477542991 | Gracemore, LLC | Skilled Nursing Facility | 2708 Lee St, Brunswick, GA 31520-4932 | 2005-10-18 |
| 1851380372 | Sears Nursing Home, LLC | Skilled Nursing Facility | 3311 Lee St, Brunswick, GA 31520-4120 | 2005-10-18 |
| 1396748612 | Progressive Rolling Hills, LLC | Skilled Nursing Facility | 4426 Homestead Dr, Brunswick, OH 44212-2506 | 2005-05-31 |
| 1922540848 | Jukeco Enterprises LLC | Skilled Nursing Facility | 721 W Harrison St, Brunswick, MO 65236-1096 | 2016-11-09 |
| 1619135464 | Southeast Georgia Health System, Inc. | Skilled Nursing Facility | 2611 Wildwood Dr, Brunswick, GA 31520-4250 | 2008-05-29 |
| 1609922020 | Willowood Care Center of Brunswick Inc | Skilled Nursing Facility | 1186 Hadcock Rd, Brunswick, OH 44212-3016 | 2007-01-26 |
| 1306869003 | Glynn-brunswick Memorial Hospital Authority | Skilled Nursing Facility | 2415 Parkwood Dr, Brunswick, GA 31520-4722 | 2006-07-25 |
| Find all providers in BRUNSWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.