Healthcare Provider Details

I. General information

NPI: 1295726743
Provider Name (Legal Business Name): JOHN M REED HOME FOR THE AGED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 JOHN M REED RD
LIMESTONE TN
37681-2682
US

IV. Provider business mailing address

124 JOHN M REED RD
LIMESTONE TN
37681-2682
US

V. Phone/Fax

Practice location:
  • Phone: 423-257-6122
  • Fax: 423-257-2609
Mailing address:
  • Phone: 423-257-6122
  • Fax: 423-257-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberACL0000000004
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number0000000293
License Number StateTN

VIII. Authorized Official

Name: JAN FORD
Title or Position: ADMINISTRATOR
Credential: NHA/ALA
Phone: 423-257-6122