Community Progress Committee Inc. the Pavilion CPC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

300 Issued in TN

Legal business name

COMMUNITY PROGRESS COMMITTEE INC. THE PAVILION CPC

Practice address

152 S College St
Lebanon, TN 37087-3643

Phone

(228) 875-5447

NPI assigned

Sep 7, 2007

Organization subpart

No

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

Authorized official

Name

Greg Arnold

Title

Manager

Phone

(228) 875-5447

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1184819740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1194",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370881194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 S COLLEGE ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873643",
            "telephone_number": "228-875-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PROGRESS COMMITTEE INC. THE PAVILION CPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "228-875-5447"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440606",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.