# DIVERSICARE LEASING LP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DLC GP LLC
- **Other names:** Diversicare of Claiborne
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124016241
- **Legal business name:** DLC GP LLC
- **Authorized official:** MATTHEW J. WEISHAAR (CFO/SECRETARY)
- **Authorized official phone:** (615) 550-9459

## Contact information

- **Practice address:** 902 BUCHANAN RD, NEW TAZEWELL, TN 37825-7410
- **Practice address phone:** (423) 626-8215
- **Practice address fax:** (423) 626-0676
- **Mailing address:** 902 BUCHANAN RD, NEW TAZEWELL, TN 37825-7410
- **Mailing address phone:** (423) 626-8215
- **Mailing address fax:** (423) 626-0676

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0000000039 | TN | Yes |

## Other

- **Enumeration date:** 10/12/2005
- **Last updated:** 01/19/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 744-0453 | — | TN |