Provider Demographics
NPI:1558386433
Name:RICHLAND PLACE INC
Entity Type:Organization
Organization Name:RICHLAND PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-292-4900
Mailing Address - Street 1:504 ELMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2508
Mailing Address - Country:US
Mailing Address - Phone:615-292-4900
Mailing Address - Fax:
Practice Address - Street 1:504 ELMINGTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2508
Practice Address - Country:US
Practice Address - Phone:615-292-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN309314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
0413096OtherHEALTH SPRING
TN1000655OtherBCBS
TN445166Medicare Oscar/Certification