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Contact Information

CHRISTIAN CARE CENTER OF BOLIVAR LLC
10160 HIGHWAY 64W
BOLIVAR, TN38008
 Phone: 423-975-5455
 Fax: 423-390-0743
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for CHRISTIAN CARE CENTER OF BOLIVAR LLC

NPI Number 1972181998
LBN Legal business name CHRISTIAN CARE CENTER OF BOLIVAR LLC
Authorized official LISA CAWOOD GRAY - (DELEGATED OFFICIAL, REGISTRATIONS O)
Entity Organization
Organization subpart 1 No
Enumeration date 03/31/2021
Last updated 01/31/2022 - About 4 years ago
Identifiers n/a
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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