MEDICARE: HARBOR VIEW NURSING AND REHABILITATION CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility	0235	TN
2	314000000X	Skilled Nursing Facility	0000000235	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053375634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR VIEW NURSING AND REHABILITATION CENTER, LLC

Provider Business Mailing Address
First Line	:	PO BOX 10
Second Line	:
City	:	PARSONS
State	:	TN
Zip	:	38363-0010
Country	:	US
Telephone Number	:	731-847-6343
Fax Number	:	731-847-4200

Provider Business Practice Location Address
First Line	:	1513 N 2ND ST
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38107
Country	:	US
Telephone Number	:	901-272-2494
Fax Number	:	901-272-1387

Authorized Official
Title or Position	:	SECRETARY
Name	:	MS. ROBIN F BRADLEY
Credential	:
Telephone Number	:	615-595-8383

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	05/03/2021

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