Healthcare Provider Details

I. General information

NPI: 1942245816
Provider Name (Legal Business Name): INTEGRITY HEALTHCARE OF JONESBOROUGH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PERSIMMON RIDGE RD
JONESBOROUGH TN
37659-5239
US

IV. Provider business mailing address

1101 PERSIMMON RIDGE RD
JONESBOROUGH TN
37659-5239
US

V. Phone/Fax

Practice location:
  • Phone: 423-753-8711
  • Fax: 423-753-8729
Mailing address:
  • Phone: 423-753-8711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number292
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7440540
Identifier TypeMEDICAID
Identifier StateTN
Identifier Issuer

VIII. Authorized Official

Name: MRS. ALICE MARIE CLARK DANKS
Title or Position: VP OF FINANCE
Credential: CPA
Phone: 423-308-1845