SOUTHERN MANOR LIVING CENTERS OF LEBANON, LLC (NPI# 1891032710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891032710 |
| Entity Type | Organization |
| Organization Name | SOUTHERN MANOR LIVING CENTERS OF LEBANON, LLC |
| Practice Address |
900 Coles Ferry Pike Lebanon TN 37087-5677 |
| Practice Telephone | 6154437929 |
| Practice Fax Number | 6154437502 |
| Mailing Telephone | 6154437929 |
| Mailing Fax Number | 6154437502 |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |
| Authorized Official Name | MRS. JENNIFER A BRADSHAW (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6154437929 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | ACL0000000158 | TN | Nursing & Custodial Care Facilities |
| Street Address |
900 COLES FERRY PIKE |
| City | LEBANON |
| State | TN |
| Zip Code | 37087-5677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841834652 | Lebanon Operator LLC | Assisted Living Facility | 900 Coles Ferry Pike, Lebanon, TN 37087-5677 | 2019-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051698 | Results-ast Jv, LLC | Physical Therapist | 1420 West Baddour Parkway, Suite 102, Lebanon, TN 37087 | 2020-10-19 |
| 1306405725 | Angela Kurtz | Hearing Instrument Specialist | 1430 West Baddour Parkwayste D, Lebanon, TN 37087 | 2019-06-10 |
| 1164926937 | Andrea Christine Morrisett | Physical Therapist | 404 N Castle Heights Ave Ste G, Lebanon, TN 37087 | 2018-03-19 |
| 1942731492 | Rocky Mountain Holdings, LLC | Ambulance | 760d Franklin Rd, Lebanon, TN 37087 | 2017-03-27 |
| 1326409285 | Karina Lawrence | Speech-Language Pathologist | 1006 Keaton Street, Lebanon, TN 37087 | 2016-03-18 |
| 1174910491 | Yehualashet Bekele Hailemariam | Internal Medicine | 1411 W Baddour Pkwy,lebanon Tn 37087, Lebanon, TN 37087 | 2015-04-24 |
| 1043614829 | Jean Thompson | Behavioral Analyst | 1004 Hickory Hill Lane, Suite 2, Hermitage, TN 37087 | 2014-10-22 |
| 1588072771 | La Keisha Fair | Community Health Worker | 1 Cumberland Square, Lebanon, TN 37087 | 2014-07-31 |
| 1023440609 | James Martin Meadows | Specialist/Technologist | One Cumberland Square, Lebanon, TN 37087 | 2013-08-06 |
| 1336571231 | Lori Ann De Leo | Social Worker | 109 Autumn Creek, Lebanon, TN 37087 | 2013-08-01 |
| Find all providers in zip 37087 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326664947 | Fm Oaks, LLC | Assisted Living Facility | 621 W Oak St, Lebanon, OR 97355-1788 | 2020-06-19 |
| 1164085577 | Otterbein Lebanon | Assisted Living Facility | 585 North State Route 741, Lebanon, OH 45036-8839 | 2019-04-22 |
| 1427401546 | Bellwood Assisted Living LLC | Assisted Living Facility | 3190 Carthage Hwy, Lebanon, TN 37087-9564 | 2016-07-14 |
| 1720416399 | Al Lebanon Operations, LLC | Assisted Living Facility | 860 Norman Dr, Lebanon, PA 17042-7499 | 2013-10-17 |
| 1043520133 | Countryside Home, LLC | Assisted Living Facility | 24499 Park Dr, Lebanon, MO 65536-5843 | 2010-10-07 |
| 1467640631 | Alice Peck Day Health Systems | Assisted Living Facility | 121 Mascoma St, Lebanon, NH 03766-2610 | 2007-10-12 |
| 1225244940 | Bristol Care, Inc. | Assisted Living Facility | 1316 Deadra Dr, Lebanon, MO 65536-4609 | 2007-05-16 |
| 1487771275 | Century Fields | Assisted Living Facility | 181 S 5th St, Lebanon, OR 97355-2711 | 2007-03-25 |
| 1306970025 | Krn-dns Inc. | Assisted Living Facility | 31841 Highway 5, Lebanon, MO 65536-6898 | 2007-03-15 |
| 1922166115 | Open Options Inc. | Assisted Living Facility | 1073 Oregonia Rd Ste A, Lebanon, OH 45036-7532 | 2006-12-04 |
| Find all providers in LEBANON | ||||
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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.