Provider Demographics
NPI:1700886868
Name:HARPETH TERRACE CONVALESCENT CENTER
Entity Type:Organization
Organization Name:HARPETH TERRACE CONVALESCENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-794-8417
Mailing Address - Street 1:1287 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3333
Mailing Address - Country:US
Mailing Address - Phone:615-794-8417
Mailing Address - Fax:615-794-7833
Practice Address - Street 1:1287 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3333
Practice Address - Country:US
Practice Address - Phone:615-794-8417
Practice Address - Fax:615-794-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0445146Medicaid
TN66085OtherBC/BS
TN66085OtherBC/BS