Provider Demographics
NPI:1639625254
Name:EMERALD SPRING HILL, INC.
Entity Type:Organization
Organization Name:EMERALD SPRING HILL, INC.
Other - Org Name:THE RESERVE AT SPRING HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLASS
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-647-9004
Mailing Address - Street 1:PO BOX 159098
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-9098
Mailing Address - Country:US
Mailing Address - Phone:615-604-0628
Mailing Address - Fax:859-281-5150
Practice Address - Street 1:2000 RESERVE BOULEVARD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2370
Practice Address - Country:US
Practice Address - Phone:615-604-0628
Practice Address - Fax:859-281-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN411OtherTENNESSEE NURSING HOME PERMIT