Organization
SOUTHERN MANOR LIVING CENTERS OF WINCHESTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY DAWN GULLEY LPN (EXECUTIVE DIRECTOR)
(931) 967-9765
Entity
Organization
Contact information
Practice address
3619 COWAN HWY, WINCHESTER, TN 37398-4709
(931) 967-9765
(931) 967-7487
Mailing address
3619 COWAN HWY, WINCHESTER, TN 37398-4709
(931) 967-9765
(931) 967-7487
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ACL0000000191
TN
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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