# OVERTON COUNTY HEALTH AND REHAB CENTER

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

## Provider details

- **NPI number:** 1790786614
- **Authorized official:** MRS. JENNIFER BOULDIN NHA (ADMINISTRATOR)
- **Authorized official phone:** (931) 823-6403

## Contact information

- **Practice address:** 318 BILBREY ST, LIVINGSTON, TN 38570-1706
- **Practice address phone:** (931) 823-6403
- **Practice address fax:** (931) 823-7836
- **Mailing address:** 318 BILBREY ST, LIVINGSTON, TN 38570-1706
- **Mailing address phone:** (931) 823-6403
- **Mailing address fax:** (931) 823-7836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 0000000200 | TN | — |
| 314000000X | Skilled Nursing Facility | 0000000200 | TN | Yes |

## Other

- **Enumeration date:** 08/02/2005
- **Last updated:** 03/12/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0445419 | — | TN |
| 01 | — | 106838 | SKILLED NURSING FACILITY | TN |
| 05 | — | 7440219 | — | TN |