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Organization
SLF NO. 1 LLC
Active
Organization
SLF NO. 1 LLC
Active
Other names
Wyndridge Health & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN BREWER (ADMINISTRATOR)
(931) 484-6129
Entity
Organization
Contact information
Practice address
456 WAYNE AVE, CROSSVILLE, TN 38555-4206
(931) 484-6129
(931) 484-2685
Mailing address
456 WAYNE AVE, CROSSVILLE, TN 38555-4206
(931) 484-6129
(931) 484-2685
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000312
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
445304
MEDICARE SKILLED
TN
Enumeration date
08/03/2006
Last updated
08/18/2016
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