Provider Demographics
NPI:1093946782
Name:BEAR CREEK LESSEE LLC
Entity Type:Organization
Organization Name:BEAR CREEK LESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:EARLE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:615-255-0009
Mailing Address - Street 1:611 COMMERCE ST
Mailing Address - Street 2:SUITE 3125
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-3742
Mailing Address - Country:US
Mailing Address - Phone:615-255-0009
Mailing Address - Fax:615-242-1822
Practice Address - Street 1:8041 STATE ROAD 52
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6726
Practice Address - Country:US
Practice Address - Phone:727-863-5488
Practice Address - Fax:727-862-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility