Provider Demographics
NPI:1689961104
Name:WHITWELL SENIOR LIVING, LLC
Entity Type:Organization
Organization Name:WHITWELL SENIOR LIVING, LLC
Other - Org Name:VALLEY VIEW ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-658-0100
Mailing Address - Street 1:101 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WHITWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37397-5272
Mailing Address - Country:US
Mailing Address - Phone:423-658-0100
Mailing Address - Fax:423-658-3357
Practice Address - Street 1:13960 HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:WHITWELL
Practice Address - State:TN
Practice Address - Zip Code:37397-5366
Practice Address - Country:US
Practice Address - Phone:423-658-0100
Practice Address - Fax:423-658-3357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACL0000000219310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4259475Medicaid