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General NPI Number Information
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NPI Number | 1891131801
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Entity Type | Organization
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Legal Business Name | NORTHCLIFF, ACLF
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 14691 HIGHWAY 22 N
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City | LEXINGTON
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State | TN
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Zip | 38351-4825
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Country | US
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Telephone | 731-249-5970
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Fax |
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Provider Business Mailing Address
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Address Line | 14691 HIGHWAY 22 N
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City | LEXINGTON
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State | TN
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Zip | 38351-4825
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Country | US
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Telephone | 731-249-5970
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Fax |
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Authorized Official
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Title or Position | FACILITY DIRECTOR, STAFF NURSE
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Name | MRS. CAROLYN DAVIS
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Credential | RN
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Telephone | 731-549-7290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | ACL0000000369
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License Number State | TN
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