Provider Demographics
NPI:1255851226
Name:LENOIR HEALTHCARE, LLC
Entity Type:Organization
Organization Name:LENOIR HEALTHCARE, LLC
Other - Org Name:TRINITY HEALTH AND REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
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:423-584-6755
Mailing Address - Street 1:700 WILLIAMS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-7375
Mailing Address - Country:US
Mailing Address - Phone:865-986-3583
Mailing Address - Fax:
Practice Address - Street 1:700 WILLIAMS FERRY RD
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-7375
Practice Address - Country:US
Practice Address - Phone:865-986-3583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ045614Medicaid
TNQ033390Medicaid