| NPI | 1508866898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK KING Administrator 615-893-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0000000219) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2008-11-26 |