Organization
CENTERVILLE MEDICAL INVESTORS, LLC
Active
Other names
Life Care Center of Centerville
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY S CROSS (ASSISTANT SECRETARY)
(423) 473-5867
Entity
Organization
Contact information
Practice address
112 OLD DICKSON ROAD, CENTERVILLE, TN 37033
(931) 729-4236
(931) 729-5489
Mailing address
3001 KEITH ST NW, CLEVELAND, TN 37312-3713
(423) 473-5751
(423) 339-8342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
131
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-0350
—
TN
Enumeration date
06/23/2006
Last updated
02/12/2008
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