# CENTER ON AGING AND HEALTH LLC

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

## Provider details

- **NPI number:** 1427040211
- **Authorized official:** MR. CHRISTOPHER ALEX GADDY (ADMINISTRATOR)
- **Authorized official phone:** (423) 743-7669

## Contact information

- **Practice address:** 880 S MOHAWK DR, ERWIN, TN 37650-2125
- **Practice address phone:** (423) 743-7669
- **Practice address fax:** (423) 735-1160
- **Mailing address:** 880 S MOHAWK DR, ERWIN, TN 37650-2125
- **Mailing address phone:** (423) 743-7669
- **Mailing address fax:** (423) 735-1160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 378 | TN | Yes |

## Other

- **Enumeration date:** 08/17/2005
- **Last updated:** 04/06/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0445424 | — | TN |
| 01 | — | 4008444 | BLUCCROSSBLUESHIELD | TN |
| 05 | — | 7440598 | — | TN |