Organization
BRADLEY COUNTY NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH H NEWCOMB (ADMINISTRATOR)
(423) 472-7116
Entity
Organization
Contact information
Practice address
2910 PEERLESS RD NW, CLEVELAND, TN 37312-3742
(423) 472-7116
Mailing address
2910 PEERLESS RD NW, CLEVELAND, TN 37312-3742
(423) 472-7116
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0345040001
DEMERC/PALMETTO
TN
05
—
0445141
—
TN
05
—
7440017
—
TN
Enumeration date
10/11/2005
Last updated
12/01/2010
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