Organization
TRI-COUNTY CONVALESCENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA PICKENS (ADMINISTRATOR)
(731) 632-3301
Entity
Organization
Contact information
Practice address
409 PARK AVE, ADAMSVILLE, TN 38310-2461
(731) 632-3301
(731) 632-4111
Mailing address
409 PARK AVE, ADAMSVILLE, TN 38310-2461
(731) 632-3301
(731) 632-4111
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000167
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445397
—
TN
05
—
7440195
—
TN
Enumeration date
05/31/2005
Last updated
07/25/2007
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