Provider Demographics
NPI:1245510940
Name:BAILEY MANOR
Entity type:Organization
Organization Name:BAILEY MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:931-728-9045
Mailing Address - Street 1:1707 MCMINNVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-3137
Mailing Address - Country:US
Mailing Address - Phone:931-728-9045
Mailing Address - Fax:931-728-9055
Practice Address - Street 1:1707 MCMINNVILLE HWY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3137
Practice Address - Country:US
Practice Address - Phone:931-728-9045
Practice Address - Fax:931-728-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACL0000000268311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)