| NPI | 1669534566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH WELLMAN Administrator 423-775-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 00000000208) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-11-19 |