Bailey Park Community Living Center

LBN: Clc Of Humboldt, Llc
Bailey Park Community Living Center is an health care organization with primary practice located at 2400 E Mitchell St , Humboldt TN 38343-3036. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Clc Of Humboldt, Llc can be contacted via phone (731) 784-5183, or through Wright, Douglas M. via phone (662) 680-3148.

Contact Information

Primary practice address
2400 E Mitchell St Humboldt TN 38343-3036
Phone: (731) 784-5183
Fax: (731) 784-1562
Website:
Map and Directions
Authorized official contact:
Name: Wright, Douglas M.
Phone: (662) 680-3148

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 0000000088 Tennessee

Profile Details

NPI number 1275523854
LBN Legal business name Clc Of Humboldt, Llc
DBA Doing business as Bailey Park Community Living Center
Authorized official Wright, Douglas M.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2005
Last updated Jan 28th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275523854 NPPES
Tennessee MEDICAID 744-0208

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