Organization
HOLSTON NH OPERATIONS LLC
Active
Other names
Holston Manor
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA B NELSON (CONTROLLER)
(864) 578-6599
Entity
Organization
Contact information
Practice address
3641 MEMORIAL BLVD, KINGSPORT, TN 37664-3422
(423) 246-2411
(423) 246-8997
Mailing address
3641 MEMORIAL BLVD, KINGSPORT, TN 37664-3422
(423) 246-2411
(423) 246-8997
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000264
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445295
—
TN
05
—
7440436
—
TN
Enumeration date
07/09/2008
Last updated
05/13/2015
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