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Contact Information

COUNTRY PLACE HEALTH CARE CENTER
80 JUSTICE STREET
CROSSVILLE, TN38555
 Phone: 931-484-4782
 Fax: 931-456-0309
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for COUNTRY PLACE HEALTH CARE CENTER

NPI # 1073523692
LBN Legal business name COUNTRY PLACE HEALTH CARE CENTER
Authorized official CYNTHIA WILSON - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/08/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
TN License # 0000000285
TN Medicaid 0445167
TN Medicaid 7440421
TN Other 50919 BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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