Organization
ABODE CARE PARTNERS LTC VB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
(502) 420-2512
Entity
Organization
Contact information
Practice address
919 MEDICAL PARK DR, MOUNTAIN CITY, TN 37683-1042
(423) 727-7800
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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