Organization
COUNTRY COTTAGE - RCL, LLC
Active
Other names
Country Cottage
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF WHITE (PRESIDENT)
(256) 536-5992
Entity
Organization
Contact information
Practice address
469 WEAKLEY CREEK RD, LAWRENCEBURG, TN 38464-5327
(931) 766-0660
Mailing address
469 WEAKLEY CREEK RD, LAWRENCEBURG, TN 38464-5327
(931) 766-0660
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ACL0000000168
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01323935
AMERIGROUP
TN
01
—
1285071282
UNITED HEALTHCARE
TN
01
—
A3846400
AMERICHOICE
TN
05
—
H445176
—
TN
Enumeration date
05/30/2013
Last updated
01/07/2014
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