# EXTENDICARE OF WEST TN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LHC GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356606735
- **Legal business name:** LHC GROUP
- **Authorized official:** MRS. SHELLEY DAWN KING PTA (HYSICAL THERAPIST ASSISTANT)
- **Authorized official phone:** (731) 660-2171

## Contact information

- **Practice address:** 250 N PARKWAY, SUITE 4, JACKSON, TN 38305-2735
- **Practice address phone:** (731) 668-1372
- **Practice address fax:** (731) 664-9919
- **Mailing address:** 97 THORNFIELD DR, BELLS, TN 38006-5128
- **Mailing address phone:** (731) 660-2171
- **Mailing address fax:** (731) 660-2171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | 4019 | TN | — |
| 251E00000X | Home Health Agency | 4019 | TN | Yes |

## Other

- **Enumeration date:** 07/11/2012
- **Last updated:** 07/11/2012