Organization
TENNESSEE STATE VETERANS HOME BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ROSS (CHAIRMAN)
(615) 225-1816
Entity
Organization
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 784-8405
(731) 784-2448
Mailing address
P.O. BOX 11328, MURFREESBORO, TN 37129
(615) 225-1816
(615) 898-1181
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0000000346
TN
314000000X
Skilled Nursing Facility
Primary
0000000346
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445366
—
TN
01
—
3030638
BLUECROSS BLUESHIELD
TN
05
—
7440578
—
TN
Enumeration date
08/25/2005
Last updated
08/13/2025
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