Provider Demographics
NPI:1457333155
Name:SPRING MEADOWS HEALTH CARE CENTER LLC
Entity Type:Organization
Organization Name:SPRING MEADOWS HEALTH CARE CENTER LLC
Other - Org Name:SPRING MEADOWS HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-552-0181
Mailing Address - Street 1:220 HIGHWAY 76
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4102
Mailing Address - Country:US
Mailing Address - Phone:931-552-0181
Mailing Address - Fax:931-552-9683
Practice Address - Street 1:220 HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4102
Practice Address - Country:US
Practice Address - Phone:931-552-0181
Practice Address - Fax:931-552-9683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7440500Medicaid
TN7440500Medicaid