TRI-AGE ADVENTURES, INC. (NPI# 1699872879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699872879 |
| Entity Type | Organization |
| Organization Name | TRI-AGE ADVENTURES, INC. |
| Other Organization Name | KNOLLWOOD MANOR |
| Practice Address |
405 Times Ave Lafayette TN 37083-1247 |
| Practice Telephone | 6156663170 |
| Practice Fax Number | 6156669146 |
| Mailing Telephone | 6156663170 |
| Mailing Fax Number | 6156669146 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. LINDA RUTH AUSTIN (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 6156663170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 168 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 0445410 | 05 | |
| TN | 7440570 | 05 |
| Other Name | Type Code |
|---|---|
| Knollwood Manor | Doing Business As Name - Organization |
| Street Address |
405 TIMES AVE |
| City | LAFAYETTE |
| State | TN |
| Zip Code | 37083-1247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467995613 | Osarugue Grace Richards | Nurse Practitioner | 209 College Street, Lafayette, TN 37083 | 2016-11-21 |
| 1619332202 | Lindsey Carr | Licensed Practical Nurse | 601 Highway 52 By Pass East, Lafayette, TN 37083 | 2015-12-23 |
| 1275888992 | Jamii Johnson | Family Medicine | 200 Highway 52 Byp E Ste D, Lafayette, TN 37083 | 2012-07-18 |
| 1740572767 | John Steven Conger | Pharmacist | 320 Hwy 52 Bypass W, Rite Aid Pharmacy, Lafayette, TN 37083 | 2011-05-10 |
| 1871719294 | Kathryn Ann Fitzgerald | Pharmacist | 320 Hwy 52 Bypass West, Lafayette, TN 37083 | 2007-04-17 |
| 1770619777 | Brande Nicole Pharris | Registered Nurse | 601 Hwy Bypass 52, Tn Dept of Health, Lafayette, TN 37083 | 2007-02-26 |
| 1528194529 | Kelly Renae Ritter | Nurse's Aide | 601 Hwy 52 Bypass East, Tn Dept of Health, Lafayette, TN 37083 | 2007-02-26 |
| 1942336946 | Tammy Michelle Driver | Registered Nurse | 601 Highway 52 Bypass East, Tn Dept of Health, Lafayette, TN 37083 | 2007-02-26 |
| 1144395948 | Larry C Key | Dentist | 726 Hwy 52 By Pass W, Lafayette, TN 37083 | 2006-11-21 |
| 1689745069 | Family Care Center LLC | Family Medicine | 207 West Locust Street, Lafayette, TN 37083 | 2006-11-10 |
| Find all providers in zip 37083 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
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| 1912278391 | Jordan Russell Carver | Skilled Nursing Facility | 203 Mai Ridge Lane, Lafayette, TN 37083-4477 | 2012-01-18 |
| 1700118262 | Hancock Regional Hospital | Skilled Nursing Facility | 1750 S Creasy Ln, Lafayette, IN 47905-4911 | 2010-02-09 |
| 1538356936 | Cornerstone Village South, Inc | Skilled Nursing Facility | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2007-09-28 |
| 1366520090 | Nurses Alliance Corporation | Skilled Nursing Facility | 1010 1st Street, Lafayette, CA 94549 | 2006-11-01 |
| 1649288572 | Andover Rehab Center Services Two Inc | Skilled Nursing Facility | 99 Mulford Road, Lafayette, NJ 07848 | 2006-08-04 |
| 1861420408 | Lafayette Nursing Home LLC | Skilled Nursing Facility | 555 B Street, Lafayette, AL 36862-0109 | 2006-06-30 |
| 1205878097 | Lafayette Extended Care | Skilled Nursing Facility | 805 Hospital St, Lafayette, AL 36862-2817 | 2006-06-13 |
| 1194764563 | Franciscan Communities, Inc. | Skilled Nursing Facility | 2201 Cason St, Lafayette, IN 47904-2613 | 2006-06-04 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.