Provider Demographics
NPI:1891235453
Name:ROCKGATE ASSISTED LIVING FACILITY LLC
Entity Type:Organization
Organization Name:ROCKGATE ASSISTED LIVING FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-962-9777
Mailing Address - Street 1:328 CUMBERLAND ST W
Mailing Address - Street 2:
Mailing Address - City:COWAN
Mailing Address - State:TN
Mailing Address - Zip Code:37318-3112
Mailing Address - Country:US
Mailing Address - Phone:931-962-9777
Mailing Address - Fax:931-962-9911
Practice Address - Street 1:328 CUMBERLAND ST W
Practice Address - Street 2:
Practice Address - City:COWAN
Practice Address - State:TN
Practice Address - Zip Code:37318-3112
Practice Address - Country:US
Practice Address - Phone:931-962-9777
Practice Address - Fax:931-962-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility