Organization
DYER NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY PARK (ADMINISTRATOR)
(731) 692-4545
Entity
Organization
Contact information
Practice address
1124 NORTH MAIN, DYER, TN 38330-0160
(731) 692-4545
(731) 692-4447
Mailing address
PO BOX 160, DYER, TN 38330-0160
(731) 692-4545
(731) 692-4447
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
351
TN
314000000X
Skilled Nursing Facility
351
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7440580
—
TN
Enumeration date
02/13/2007
Last updated
06/23/2020
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