Healthcare Provider Details

I. General information

NPI: 1962857763
Provider Name (Legal Business Name): THE CRESTVIEW CARE AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 25TH AVE N
NASHVILLE TN
37208-1369
US

IV. Provider business mailing address

2030 25TH AVE N
NASHVILLE TN
37208-1369
US

V. Phone/Fax

Practice location:
  • Phone: 615-256-4697
  • Fax: 615-256-4616
Mailing address:
  • Phone: 615-256-4697
  • Fax: 615-256-4616

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