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Organization
CHRISTIAN CARE CENTER OF SPRINGFIELD LLC
Active
Organization
CHRISTIAN CARE CENTER OF SPRINGFIELD LLC
Active
Other names
Christian Care Center Of Springfield
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY R LEWIS (CHIEF MANAGER)
(423) 975-5455
Entity
Organization
Contact information
Practice address
704 5TH AVE E, SPRINGFIELD, TN 37172-2604
(615) 384-7977
(615) 382-1023
Mailing address
704 5TH AVE E, SPRINGFIELD, TN 37172-2604
(615) 384-7977
(615) 382-1023
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0000000214
TN
314000000X
Skilled Nursing Facility
Primary
0000000214
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445480
—
TN
05
—
7440061
—
TN
Enumeration date
12/01/2005
Last updated
03/06/2008
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