| NPI | 1376066134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY R. LEWIS Chief Manager 423-975-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN TN0000000260) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN TN0000000260) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2018-06-16 |