# CHRISTIAN CARE CENTER OF MCKENZIE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194244772
- **Authorized official:** LISA M CAWOOD GRAY (MANAGER, RISK MANAGEMENT)
- **Authorized official phone:** (423) 557-6116

## Contact information

- **Practice address:** 150 OAK MANOR RD, MC KENZIE, TN 38201
- **Practice address phone:** (731) 352-5317
- **Practice address fax:** (731) 352-5942
- **Mailing address:** 2020 NORTHPARK DR STE 2D, JOHNSON CITY, TN 37604-3127
- **Mailing address phone:** (423) 557-6116
- **Mailing address fax:** (423) 975-5405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/14/2017
- **Last updated:** 06/22/2018