# JELLICO TN OPCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beech Tree Health and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770049504
- **Authorized official:** DAVID HERSKOWITZ (CEO)
- **Authorized official phone:** (212) 444-1991

## Contact information

- **Practice address:** 240 HOSPITAL LN, JELLICO, TN 37762-4401
- **Practice address phone:** (423) 784-6626
- **Mailing address:** 2071 FLATBUSH AVE STE 12, BROOKLYN, NY 11234-4340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/18/2019
- **Last updated:** 02/07/2023