Organization
OVERTON COUNTY HEALTH AND REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER BOULDIN NHA (ADMINISTRATOR)
(931) 823-6403
Entity
Organization
Contact information
Practice address
318 BILBREY ST, LIVINGSTON, TN 38570-1706
(931) 823-6403
(931) 823-7836
Mailing address
318 BILBREY ST, LIVINGSTON, TN 38570-1706
(931) 823-6403
(931) 823-7836
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0000000200
TN
314000000X
Skilled Nursing Facility
Primary
0000000200
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445419
—
TN
01
—
106838
SKILLED NURSING FACILITY
TN
05
—
7440219
—
TN
Enumeration date
08/02/2005
Last updated
03/12/2015
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