Healthcare Provider Details

I. General information

NPI: 1639300320
Provider Name (Legal Business Name): AYERS LESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 NE 7TH ST
TRENTON FL
32693-3636
US

IV. Provider business mailing address

611 COMMERCE ST SUITE 3125
NASHVILLE TN
37203-3742
US

V. Phone/Fax

Practice location:
  • Phone: 352-463-7101
  • Fax: 352-463-7710
Mailing address:
  • Phone: 615-255-0009
  • Fax: 615-242-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMES P. EARLE III
Title or Position: PRESIDENT
Credential:
Phone: 615-255-0009