Organization
COMMUNITY PROGRESS COMMITTEE INC. THE PAVILION CPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG ARNOLD (MANAGER)
(228) 875-5447
Entity
Organization
Contact information
Practice address
152 S COLLEGE ST, LEBANON, TN 37087-3643
(228) 875-5447
Mailing address
PO BOX 1194, LEBANON, TN 37088-1194
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
300
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7440606
—
TN
Enumeration date
09/07/2007
Last updated
05/12/2009
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