Provider Demographics
NPI:1154344539
Name:MOUNTAIN VIEW ASSISTED LIVING OF LOUDON, LLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW ASSISTED LIVING OF LOUDON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:STINNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-458-6240
Mailing Address - Street 1:110 RIVER RD W
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-5418
Mailing Address - Country:US
Mailing Address - Phone:865-458-6240
Mailing Address - Fax:865-458-6647
Practice Address - Street 1:110 RIVER RD W
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-5418
Practice Address - Country:US
Practice Address - Phone:865-458-6240
Practice Address - Fax:865-458-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACL0000000053310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility