Organization
COVENANT LIVING AT SHANNONDALE
Active
Other names
Shannondale of Maryville
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH A MALZAHN (SVP REIMBURSEMENT)
(773) 878-4430
Entity
Organization
Contact information
Practice address
803 SHANNONDALE WAY, MARYVILLE, TN 37803-5972
(865) 982-4599
(865) 982-3786
Mailing address
801 VANOSDALE RD, KNOXVILLE, TN 37909-2497
(865) 690-3411
(865) 246-1799
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TN
Other
Enumeration date
07/06/2005
Last updated
11/04/2024
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