Organization
BOLIVAR ASSISTED CARE LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG BRADFORD LAMAN (MEMBER)
(731) 696-4670
Entity
Organization
Contact information
Practice address
631 NUCKOLLS RD, BOLIVAR, TN 38008-1599
(731) 658-3313
(731) 658-9889
Mailing address
15 S BELLS ST, SUITE #3, ALAMO, TN 38001-1778
(731) 696-4670
(731) 696-4672
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ACL00000000182
TN
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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