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General NPI Number Information
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NPI Number | 1649252560
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Entity Type | Organization
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Legal Business Name | HUNTSVILLE NH OPERATIONS, LLC
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 287 BAKER ST
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City | HUNTSVILLE
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State | TN
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Zip | 37756-3444
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Country | US
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Telephone | 423-663-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 287 BAKER ST
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City | HUNTSVILLE
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State | TN
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Zip | 37756-3444
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Country | US
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Telephone | 423-663-3600
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CARLA D BUTTRAM
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Credential | BSM LNHA
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Telephone | 423-663-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 223
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License Number State | TN
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