# JEFFERSON COUNTY NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JEFFERSON COUNTY NURSING HOME
- **Other names:** Jefferson Park At White Pine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982324182
- **Legal business name:** JEFFERSON COUNTY NURSING HOME
- **Authorized official:** MR. ROGER LOUIS MYNATT LNHA (ADMINISTRATOR)
- **Authorized official phone:** (865) 397-3163

## Contact information

- **Practice address:** 407 LAURA LEE DR, WHITE PINE, TN 37890
- **Practice address phone:** (865) 327-4100
- **Mailing address:** 914 INDUSTRIAL PARK RD, DANDRIDGE, TN 37725-4700
- **Mailing address phone:** (865) 397-3163
- **Mailing address fax:** (865) 397-3333

## Taxonomy

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

## Other

- **Enumeration date:** 08/30/2022
- **Last updated:** 08/30/2022