Provider Demographics
NPI:1780040139
Name:NHC PLACE AT THE TRACE LLC
Entity Type:Organization
Organization Name:NHC PLACE AT THE TRACE LLC
Other - Org Name:NHC PLACE AT THE TRACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF LLC
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 1:8353 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8353 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4009
Practice Address - Country:US
Practice Address - Phone:629-888-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-14
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
445525Medicare Oscar/Certification