| NPI | 1649363979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI RENEE EDENFIELD Cota/L 865-603-4542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 0162) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-08-22 |