Provider Demographics
NPI:1184014466
Name:HALCYON SENIOR SERVICES OF BARRON, LLC
Entity Type:Organization
Organization Name:HALCYON SENIOR SERVICES OF BARRON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-227-5957
Mailing Address - Street 1:7429 ROYAL HARBOUR CIR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-9151
Mailing Address - Country:US
Mailing Address - Phone:423-826-1800
Mailing Address - Fax:
Practice Address - Street 1:7429 ROYAL HARBOUR CIR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-9151
Practice Address - Country:US
Practice Address - Phone:423-826-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility