Organization
CHRISTIAN CARE CENTER OF SPRINGFIELD LLC
Active
Other names
Christian Care Center Of Springfield
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY R LEWIS (CHIEF MANAGER)
(423) 975-5455
Entity
Organization
Contact information
Practice address
704 5TH AVE E, SPRINGFIELD, TN 37172-2604
(615) 384-7977
(615) 382-1023
Mailing address
704 5TH AVE E, SPRINGFIELD, TN 37172-2604
(615) 384-7977
(615) 382-1023
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0000000214
TN
314000000X
Skilled Nursing Facility
Primary
0000000214
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445480
—
TN
05
—
7440061
—
TN
Enumeration date
12/01/2005
Last updated
03/06/2008
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