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Organization
CENTER ON AGING AND HEALTH LLC
Active
Organization
CENTER ON AGING AND HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER ALEX GADDY (ADMINISTRATOR)
(423) 743-7669
Entity
Organization
Contact information
Practice address
880 S MOHAWK DR, ERWIN, TN 37650-2125
(423) 743-7669
(423) 735-1160
Mailing address
880 S MOHAWK DR, ERWIN, TN 37650-2125
(423) 743-7669
(423) 735-1160
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
378
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445424
—
TN
01
—
4008444
BLUCCROSSBLUESHIELD
TN
05
—
7440598
—
TN
Enumeration date
08/17/2005
Last updated
04/06/2015
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