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General NPI Number Information
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NPI Number | 1073420063
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Entity Type | Organization
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Legal Business Name | MCMINNVILLE MANOR OPCO LLC
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 345 GARFIELD ST
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City | MCMINNVILLE
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State | TN
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Zip | 37110-1914
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Country | US
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Telephone | 516-462-4963
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Fax |
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Provider Business Mailing Address
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Address Line | 55 BARRETT RD
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City | LAWRENCE
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State | NY
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Zip | 11559-2704
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Country | US
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Telephone | 516-462-4963
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YONAH COHEN
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Credential | LNHA
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Telephone | 516-462-4963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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