Organization
BRAKEBILL NURSING HOME, INC.
Active
Parent organization
BRAKEBILL NURSING HOME, INC.
Other names
Brakebill Nursing and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRAKEBILL NURSING HOME, INC.
Authorized official
MR. JAMES WILKERSON CPA (CONTROLLER)
(865) 584-3902
Entity
Organization
Contact information
Practice address
5837 LYONS VIEW PIKE, KNOXVILLE, TN 37919-6474
(865) 584-3902
(865) 584-2122
Mailing address
5837 LYONS VIEW PIKE, KNOXVILLE, TN 37919-6474
(865) 584-3902
(865) 584-2122
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0000000141
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000662
BCBS
TN
05
—
313M00000X
—
TN
Enumeration date
06/01/2005
Last updated
08/02/2007
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