Organization
CLC OF RIPLEY, LLC
Active
Other names
Lauderdale Community Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER)
(662) 680-3148
Entity
Organization
Contact information
Practice address
215 LACKEY LN, RIPLEY, TN 38063-1619
(731) 635-5100
(731) 635-5184
Mailing address
215 LACKEY LN, RIPLEY, TN 38063-1619
(731) 635-5100
(731) 635-5184
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000154
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-0559
—
TN
Enumeration date
10/25/2005
Last updated
01/28/2008
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