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Organization
ABUNDANT CHRISTIAN LIVING COMMUNITY LLC
Active
Organization
ABUNDANT CHRISTIAN LIVING COMMUNITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY R. LEWIS (CHIEF MANAGER)
(423) 975-5455
Entity
Organization
Contact information
Practice address
2012 SHERWOOD DR, JOHNSON CITY, TN 37601-3238
(423) 232-8200
(423) 232-8240
Mailing address
2020 NORTHPARK DR STE 2D, JOHNSON CITY, TN 37604-3127
(423) 975-5455
(423) 390-0743
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
NULL
313M00000X
Nursing Facility/Intermediate Care Facility
—
NULL
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Enumeration date
03/09/2021
Last updated
03/10/2021
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