Provider Demographics
NPI:1457362469
Name:PARK REST HARDIN COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:PARK REST HARDIN COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JO
Authorized Official - Middle Name:N
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-925-1181
Mailing Address - Street 1:85 SHELBY DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-3165
Mailing Address - Country:US
Mailing Address - Phone:731-925-1181
Mailing Address - Fax:731-925-8637
Practice Address - Street 1:85 SHELBY DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-3165
Practice Address - Country:US
Practice Address - Phone:731-925-1181
Practice Address - Fax:731-925-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000121313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility