Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 WALNUT GROVE RD
MEMPHIS TN
38111-3508
US

IV. Provider business mailing address

3030 WALNUT GROVE RD
MEMPHIS TN
38111-3508
US

V. Phone/Fax

Practice location:
  • Phone: 901-458-1146
  • Fax: 901-458-6680
Mailing address:
  • Phone: 901-458-1146
  • Fax: 901-458-6680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSEPH SCHWARTZ
Title or Position: MANAGER
Credential:
Phone: 201-635-1195