MEDICARE: SKYLINE OF ASHTON PLACE HEALTHCARE AND REHABILITATION 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	314000000X	Skilled Nursing Facility		TN

General Provider Information

NPI Number	:	1922522408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYLINE OF ASHTON PLACE HEALTHCARE AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	3030 WALNUT GROVE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-3508
Country	:	US
Telephone Number	:	901-458-1146
Fax Number	:	901-458-6680

Provider Business Practice Location Address
First Line	:	3030 WALNUT GROVE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-3508
Country	:	US
Telephone Number	:	901-458-1146
Fax Number	:	901-458-6680

Authorized Official
Title or Position	:	MANAGER
Name	:	JOSEPH SCHWARTZ
Credential	:
Telephone Number	:	201-635-1195

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	07/21/2022

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