Healthcare Provider Details

I. General information

NPI: 1760411607
Provider Name (Legal Business Name): ALLENBROOKE NURSING AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 12/08/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3933 ALLENBROOKE CV
MEMPHIS TN
38118-1866
US

IV. Provider business mailing address

PO BOX 428
ORCHARD PARK NY
14127-0428
US

V. Phone/Fax

Practice location:
  • Phone: 901-795-2444
  • Fax: 901-795-5378
Mailing address:
  • Phone: 716-662-4955
  • Fax: 716-667-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0000000231
License Number StateTN

VIII. Authorized Official

Name: MR. NORBERT A BENNETT
Title or Position: MANAGER
Credential:
Phone: 716-662-4955