Organization
FOREST AVENUE OPCO, LLC
Active
Other names
Pine Forest Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN THOMAS FICK (CHIEF FINANCIAL OFFICER)
(615) 250-7100
Entity
Organization
Contact information
Practice address
1116 FOREST AVE, JACKSON, MS 39206-3216
(601) 366-6461
(601) 362-4041
Mailing address
9020 OVERLOOK BLVD STE 202, BRENTWOOD, TN 37027-2755
(615) 250-7100
(615) 250-7101
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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