| NPI | 1063401875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BENNETT Administrator 423-743-4131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0000000274) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2025-07-11 |