Provider Demographics
NPI:1235603143
Name:FC TWIN HILLS OPCO LLC
Entity Type:Organization
Organization Name:FC TWIN HILLS OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEINBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-664-6500
Mailing Address - Street 1:94 TWIN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2357
Mailing Address - Country:US
Mailing Address - Phone:615-855-1979
Mailing Address - Fax:615-855-2034
Practice Address - Street 1:94 TWIN HILLS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2357
Practice Address - Country:US
Practice Address - Phone:615-855-1979
Practice Address - Fax:615-855-2034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility