Organization
WATERS OF CLINTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BLISKO (CEO)
(708) 449-1900
Entity
Organization
Contact information
Practice address
220 LONGMIRE RD, CLINTON, TN 37716-7338
(865) 457-6925
Mailing address
220 LONGMIRE RD, CLINTON, TN 37716-7338
(865) 457-6925
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/08/2016
Last updated
04/06/2023
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