BSK Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BSK ENTERPRISES, LLC

Doing business as

Southern Heritage Assisted Living II

Practice address

5310 Clemons Rd BLDG 200
East Ridge, TN 37412-3108

Phone

(423) 490-0119

Fax

(423) 894-6187

NPI assigned

Aug 4, 2022

Last updated

Aug 4, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kenneth James Stonebrook

Title

Regional Director

Phone

(423) 290-8537

Specialties & licenses 1

Addresses

Other names 1

• Southern Heritage Assisted Living II Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1043947518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 CLEMONS RD BLDG 200",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374123108",
            "telephone_number": "423-490-0119",
            "fax_number": "423-894-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 CLEMONS RD BLDG 200",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374123108",
            "telephone_number": "423-490-0119",
            "fax_number": "423-894-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSK ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "STONEBROOK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "423-290-8537",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Heritage Assisted Living II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in East Ridge, TN
• Providers in East Ridge, TN by specialty
• Assisted Living Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.