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Organization

EXTENDICARE OF WEST TN

Active
Parent organization
LHC GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
LHC GROUP
Authorized official
MRS. SHELLEY DAWN KING PTA (HYSICAL THERAPIST ASSISTANT)
(731) 660-2171
Entity
Organization

Contact information

Practice address
250 N PARKWAY, SUITE 4, JACKSON, TN 38305-2735
(731) 668-1372
(731) 664-9919
Mailing address
97 THORNFIELD DR, BELLS, TN 38006-5128
(731) 660-2171
(731) 660-2171

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
4019
TN
251E00000X
Home Health Agency
Primary
4019
TN

Other

Enumeration date
07/11/2012
Last updated
07/11/2012
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