| NPI | 1902491178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY R. LEWIS Chief Manager 423-975-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-03-10 |