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General NPI Number Information
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NPI Number | 1255566121
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Entity Type | Organization
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Legal Business Name | SYCAMORES TERRACE LLC
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 1427 LEBANON PIKE
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City | NASHVILLE
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State | TN
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Zip | 37210-3100
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Country | US
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Telephone | 615-242-2412
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Fax | 615-254-6807
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Provider Business Mailing Address
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Address Line | 1427 LEBANON PIKE
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City | NASHVILLE
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State | TN
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Zip | 37210-3100
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Country | US
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Telephone | 615-242-2412
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Fax | 615-254-6807
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MR. BILL LAFOLLETTE
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Credential |
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Telephone | 615-242-2412
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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 | 0000000605
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License Number State | TN
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