Diversicare Leasing LP
Organization Active NPI Skilled Nursing Facility · New Tazewell, TN
NPI 1124016241 · NPPES record last updated Jan 19, 2023
Key facts
- NPI
- 1124016241
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0000000039 (TN)
- Legal business name
- DIVERSICARE LEASING LP
- Practice address
- 902 Buchanan Rd
New Tazewell, TN 37825-7410 - Phone
- (423) 626-8215
- Fax
- (423) 626-0676
- NPI assigned
- Oct 12, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- DLC GP LLC
Authorized official
- Name
- Matthew J. Weishaar
- Title
- Cfo/Secretary
- Phone
- (615) 550-9459
Member of 1
Practitioners 1
-
Charles H Debusk, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0000000039 | TN | Yes |
Addresses
Primary practice location
902 Buchanan Rd
New Tazewell, TN 37825-7410
Mailing address
902 Buchanan Rd
New Tazewell, TN 37825-7410
Phone (423) 626-8215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 744-0453 | Medicaid | TN |
Other names
- Diversicare of Claiborne
Other providers in New Tazewell, TN
- Ashley Damron
- Sara Elizabeth Daniels
- David G. Sanford, M.D., P.S.C.
- Charles H Debusk
- Gina Marie Defranco
- Melvin Keith Donesky
- Dr.Melvin Donesky D.D.S.
- Lacey Eldridge
- Elite Urgent Care PLLC
- Wenda Leanne Epperson
All providers in New Tazewell, TN · Skilled Nursing Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.