Organization
DIVERSICARE LEASING LP
Active
Parent organization
DLC GP LLC
Other names
Diversicare of Smyrna
Organization subpart
Yes
Provider details
NPI number
Legal business name
DLC GP LLC
Authorized official
MATTHEW J. WEISHAAR (CFO/SECRETARY)
(615) 550-9459
Entity
Organization
Contact information
Practice address
200 MAYFIELD DR, SMYRNA, TN 37167-3019
(615) 355-0350
(615) 355-5549
Mailing address
200 MAYFIELD DR, SMYRNA, TN 37167-3019
(615) 355-0350
(615) 355-5549
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000218
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-0450
—
TN
Enumeration date
10/12/2005
Last updated
01/19/2023
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