Healthcare Provider Details

I. General information

NPI: 1730020918
Provider Name (Legal Business Name): DAC OF ROCKY TOP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 INDUSTRIAL PARK LN
ROCKY TOP TN
37769-2301
US

IV. Provider business mailing address

1621 GALLERIA BLVD
BRENTWOOD TN
37027-2926
US

V. Phone/Fax

Practice location:
  • Phone: 865-426-2147
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MATTHEW J. WEISHAAR
Title or Position: CHIEF FINANCIAL OFFICER/SECRETARY
Credential:
Phone: 615-771-7575