Provider Demographics
NPI:1962500231
Name:GENERATIONS HEALTH ASSOCIATION, INC.
Entity Type:Organization
Organization Name:GENERATIONS HEALTH ASSOCIATION, INC.
Other - Org Name:GENERATIONS CENTER OF SPENCER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GREENE
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-815-1212
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:TN
Mailing Address - Zip Code:38585-0135
Mailing Address - Country:US
Mailing Address - Phone:931-946-7768
Mailing Address - Fax:931-946-7875
Practice Address - Street 1:87 GENERATIONS DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:TN
Practice Address - Zip Code:38585-3027
Practice Address - Country:US
Practice Address - Phone:931-946-7768
Practice Address - Fax:931-946-7875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN354314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7440583Medicaid
TN0445388Medicaid
TN445388Medicare Oscar/Certification