Organization
JELLICO COMMUNITY HOSPITAL, INC
Active
Other names
Care Plus Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN GHULAM (CONTROLLER)
(423) 784-1334
Entity
Organization
Contact information
Practice address
998 S HIGHWAY 25 W, WILLIAMSBURG, KY 40769-1692
(606) 549-1183
(606) 549-8107
Mailing address
188 HOSPITAL LN, JELLICO, TN 37762-4400
(423) 784-1272
(723) 784-1136
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01620848
—
KY
05
—
0440180
—
TN
Enumeration date
05/21/2008
Last updated
03/10/2016
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