# PAVILION-THS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pavilion Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518243468
- **Authorized official:** MR. GORDON BONE (VICE-PRESIDENT)
- **Authorized official phone:** (615) 417-8131

## Contact information

- **Practice address:** 1406 MEDICAL CENTER DR, LEBANON, TN 37087-8500
- **Practice address phone:** (615) 444-4343
- **Practice address fax:** (615) 444-9049
- **Mailing address:** 838 CARTHAGE HWY, LEBANON, TN 37087-4611
- **Mailing address phone:** (615) 417-8131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0000000300 | TN | Yes |

## Other

- **Enumeration date:** 10/24/2011
- **Last updated:** 10/24/2011