Provider Demographics
NPI:1982901138
Name:NASHVILLE SENIOR CARE LLC
Entity type:Organization
Organization Name:NASHVILLE SENIOR CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:HART
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:423-587-6755
Mailing Address - Street 1:4347 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1243
Mailing Address - Country:US
Mailing Address - Phone:615-871-8200
Mailing Address - Fax:
Practice Address - Street 1:4347 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1243
Practice Address - Country:US
Practice Address - Phone:615-871-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0445491Medicaid
TN7440609Medicaid
TN0445491Medicaid