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NPI Code Detail

MEDICARE: ELEVEN POINT RIVER HOLDINGS LLC

MEDICARE: ELEVEN POINT RIVER HOLDINGS 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1841121399
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELEVEN POINT RIVER HOLDINGS LLC
Provider Business Mailing Address
First Line : 115 WOODLAWN DR
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-5978
Country : US
Telephone Number : 423-975-0095
Fax Number : 423-975-0098
Provider Business Practice Location Address
First Line : 115 WOODLAWN DR
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-5978
Country : US
Telephone Number : 423-975-0095
Fax Number : 423-975-0098
Authorized Official
Title or Position : LLC MANAGER
Name : WESTON HOLT
Credential :
Telephone Number : 858-798-5700
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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Directions to “ELEVEN POINT RIVER HOLDINGS LLC ” Practice Location

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