Provider Demographics
NPI:1093925612
Name:CEDARS NURSING HOME INC.
Entity Type:Organization
Organization Name:CEDARS NURSING HOME INC.
Other - Org Name:QUALITY CARE INVESTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-444-1836
Mailing Address - Street 1:PO BOX 2789
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37088-2789
Mailing Address - Country:US
Mailing Address - Phone:615-444-1836
Mailing Address - Fax:615-453-1691
Practice Address - Street 1:932 E BADDOUR PKWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3707
Practice Address - Country:US
Practice Address - Phone:615-444-1836
Practice Address - Fax:615-453-1691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUALTIY CARE INVESTORS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-23
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0445154Medicaid
TN0445154Medicaid