Provider Demographics
NPI:1295171742
Name:MT. JULIET HEALTH CARE
Entity type:Organization
Organization Name:MT. JULIET HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:IDOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-758-4100
Mailing Address - Street 1:2650 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8015
Mailing Address - Country:US
Mailing Address - Phone:615-758-4100
Mailing Address - Fax:615-758-5450
Practice Address - Street 1:2650 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8015
Practice Address - Country:US
Practice Address - Phone:615-758-4100
Practice Address - Fax:615-758-5450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1765314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility