OrganizationActive
Department of Behavioral Health and Developmental Disabilities
NPI 1053646166 · Skilled Nursing Facility · Gracewood, GA
Provider details
- NPI number
- 1053646166
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Paul Brock, Regional Hospital Administrator(706) 790-2030
- License
- 1-121-694 (GA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
100 Myrtle Blvd
Gracewood, GA 30812-1500
Phone: (706) 790-2042
Fax: (706) 790-2476
Street-level locationGet directions
Mailing address
100 Myrtle Blvd
Gracewood, GA 30812-1500
Other names (DBA / former)
- Doing business as
- East Central Regional Hospital
Registry dates
- Enumerated
- 2009-10-07
- Last updated
- 2015-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.