Organization
HEALTH SERVICES MANCHESTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH C HART JR. (TREASURER)
(423) 584-6755
Entity
Organization
Contact information
Practice address
811 KEYLON STREET, MANCHESTER, TN 37355-2419
(931) 461-3425
Mailing address
485 CENTRAL AVE NE, CLEVELAND, TN 37311-5541
(423) 478-5953
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000033
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445383
—
TN
05
—
7440354
—
TN
Enumeration date
03/11/2011
Last updated
03/28/2019
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