Organization
CHRISTIAN CARE CENTER OF MCKENZIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M CAWOOD GRAY (MANAGER, RISK MANAGEMENT)
(423) 557-6116
Entity
Organization
Contact information
Practice address
150 OAK MANOR RD, MC KENZIE, TN 38201
(731) 352-5317
(731) 352-5942
Mailing address
2020 NORTHPARK DR STE 2D, JOHNSON CITY, TN 37604-3127
(423) 557-6116
(423) 975-5405
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/14/2017
Last updated
06/22/2018
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