Provider Demographics
NPI:1689960130
Name:MADISON ASSISTED LIVING, LTD
Entity Type:Organization
Organization Name:MADISON ASSISTED LIVING, LTD
Other - Org Name:CARESTONE ASSISTED LIVING AT RIVERGATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR V.P.
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-362-3533
Mailing Address - Street 1:94 TWIN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2357
Mailing Address - Country:US
Mailing Address - Phone:615-855-1979
Mailing Address - Fax:615-855-2034
Practice Address - Street 1:94 TWIN HILLS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2357
Practice Address - Country:US
Practice Address - Phone:615-855-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTHSTONE SENIOR SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACL0000000066310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility