Provider Demographics
NPI:1720073893
Name:KNOWLES HOME ASSISTED LIVING & DAY CARE SERVICES
Entity Type:Organization
Organization Name:KNOWLES HOME ASSISTED LIVING & DAY CARE SERVICES
Other - Org Name:J B KNOWLES HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:615-341-4491
Mailing Address - Street 1:1010 CAMILLA CALDWELL LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-3000
Mailing Address - Country:US
Mailing Address - Phone:615-862-7005
Mailing Address - Fax:615-862-6960
Practice Address - Street 1:1010 CAMILLA CALDWELL LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3000
Practice Address - Country:US
Practice Address - Phone:615-862-7005
Practice Address - Fax:615-862-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACL0000000079310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility