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General NPI Number Information
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NPI Number | 1457809782
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Entity Type | Organization
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Legal Business Name | ELCM KNOXVILLE MANAGEMENT LLC
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 801 E INSKIP DR
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City | KNOXVILLE
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State | TN
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Zip | 37912-3734
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Country | US
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Telephone | 865-357-1660
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Fax |
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Provider Business Mailing Address
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Address Line | 14241 DALLAS PKWY SUITE 650, BUILDING 3
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City | DALLAS
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State | TX
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Zip | 75254-2936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE
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Name | KEN ADLER
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Credential |
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Telephone | 972-728-8745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | ACL0000000377
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License Number State | TN
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