Organization
CLC OF DYERSBURG, LLC
Active
Other names
Oakwood 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
1636 WOODLAWN AVE, DYERSBURG, TN 38024-2026
(731) 285-6400
(731) 285-9017
Mailing address
1636 WOODLAWN AVE, DYERSBURG, TN 38024-2026
(731) 285-6400
(731) 285-9017
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000075
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-0153
—
TN
Enumeration date
10/25/2005
Last updated
01/28/2008
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