# CLC OF HARRIMAN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Renaissance Terrace
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235676156
- **Authorized official:** DOUGLAS M WRIGHT JR. (MANAGING MEMBER)
- **Authorized official phone:** (662) 680-3148

## Contact information

- **Practice address:** 257 PATTON LN, HARRIMAN, TN 37748-8618
- **Practice address phone:** (865) 354-3941
- **Mailing address:** PO BOX 3667, TUPELO, MS 38803-3667
- **Mailing address phone:** (662) 680-3148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 212 | TN | — |
| 314000000X | Skilled Nursing Facility | 212 | TN | Yes |

## Other

- **Enumeration date:** 01/30/2017
- **Last updated:** 05/26/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | Q027302 | — | TN |
| 05 | — | Q027303 | — | TN |