Organization
MADISONVILLE HEALTHCARE, LLC
Active
Other names
Madisonville Health and Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH C HART JR. (TREASURER)
(423) 584-6755
Entity
Organization
Contact information
Practice address
465 ISBILL RD, MADISONVILLE, TN 37354-2112
(423) 478-5953
Mailing address
465 ISBILL RD, MADISONVILLE, TN 37354-2112
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0186
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445457
—
TN
05
—
7440417
—
TN
Enumeration date
07/21/2015
Last updated
03/28/2019
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