Provider Demographics
NPI:1497163760
Name:COMER HOUSE OF NASHVILLE LLC
Entity Type:Organization
Organization Name:COMER HOUSE OF NASHVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:COMER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-506-5766
Mailing Address - Street 1:1603 14TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2034
Mailing Address - Country:US
Mailing Address - Phone:615-320-1862
Mailing Address - Fax:
Practice Address - Street 1:1603 14TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2034
Practice Address - Country:US
Practice Address - Phone:615-320-1862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL0000000163613104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness