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Organization
CLC OF WHITEHAVEN, LLC
Active
Organization
CLC OF WHITEHAVEN, LLC
Active
Other names
Whitehaven Community Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER)
(662) 680-3148
Entity
Organization
Contact information
Practice address
1076 CHAMBLISS RD, MEMPHIS, TN 38116-6381
(901) 396-8470
(901) 398-0271
Mailing address
PO BOX 161000, MEMPHIS, TN 38186-1000
(901) 396-8470
(901) 398-0271
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000258
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-0205
—
TN
Enumeration date
10/26/2005
Last updated
01/28/2008
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