Provider Demographics
NPI:1013108307
Name:LP SPRING CITY LLC
Entity Type:Organization
Organization Name:LP SPRING CITY LLC
Other - Org Name:SPRING CITY CARE & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIT & REIMBURSEMENT ANALYST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-568-7800
Mailing Address - Street 1:331 HINCH ST
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37381-5217
Mailing Address - Country:US
Mailing Address - Phone:423-365-4355
Mailing Address - Fax:423-365-5093
Practice Address - Street 1:331 HINCH ST
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:TN
Practice Address - Zip Code:37381-5217
Practice Address - Country:US
Practice Address - Phone:423-365-4355
Practice Address - Fax:423-365-5093
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LP CR HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-05
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN210313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7440512Medicaid
TN0445209Medicaid
6104900001Medicare NSC
TN7440512Medicaid