CLC of Harriman, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

212 Issued in TN

Legal business name

CLC OF HARRIMAN, LLC

Doing business as

Renaissance Terrace

Practice address

257 Patton LN
Harriman, TN 37748-8618

Phone

(865) 354-3941

NPI assigned

Jan 30, 2017

Last updated

May 26, 2017By 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

Douglas M Wright Jr.

Title

Managing Member

Phone

(662) 680-3148

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Renaissance Terrace Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235676156. Details of each certification follow.

• CCN 445223 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 445223

Legal name

CLC OF HARRIMAN LLC

Doing business as

RENAISSANCE TERRACE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 15, 1989

Last certification

Sep 20, 2023

Beds

130

Ownership / control type

Corporation

Multi-facility organization

Community Elder Care Service

Most recent change of ownership

Apr 1, 2017

Organization structure

LLCProprietary

Incorporated

Nov 30, 2016 in TN

Enrollment address

257 Patton LN
Renaissance Terrace
Harriman, TN 37748

Nursing home name

RENAISSANCE TERRACE

Affiliated entity

COMMUNITY ELDERCARE SERVICES

Listed as

Renaissance TerraceCCN 445223 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

May 15, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

13041.3 residents per day on average

Chain

Community Eldercare Services17 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mancel Wayne Wakham, DO

  • Family Medicine Physician
  • Harriman, TN
  • NPI 1073568218

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• CLC of Dresden, LLC

  dba Hillview Community Living Center

  • Skilled Nursing Facility
  • Dresden, TN
  • NPI 1336139088

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Dyersburg, LLC

  dba Oakwood Community Living Center

  • Skilled Nursing Facility
  • Dyersburg, TN
  • NPI 1508856295

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Lexington, LLC

  dba Briarwood Community Living Center

  • Skilled Nursing Facility
  • Lexington, TN
  • NPI 1043200777

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Ripley, LLC

  dba Lauderdale Community Living Center

  • Skilled Nursing Facility
  • Ripley, TN
  • NPI 1366432031

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Biloxi, LLC

  dba The Pillars of Biloxi

  • Skilled Nursing Facility
  • Biloxi, MS
  • NPI 1295725083

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Booneville, LLC

  dba Longwood Community Living Center

  • Skilled Nursing Facility
  • Booneville, MS
  • NPI 1447240122

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Bruce, LLC

  dba Bruce Community Living Center

  • Skilled Nursing Facility
  • Bruce, MS
  • NPI 1528249570

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Fulton, LLC

  dba Courtyards Community Living Center

  • Skilled Nursing Facility
  • Fulton, MS
  • NPI 1912997651

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Iuka, LLC

  dba Tishomingo Community Living Center

  • Skilled Nursing Facility
  • Iuka, MS
  • NPI 1457341976

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Jackson, LLC

  dba Pleasant Hills Community Living Center

  • Skilled Nursing Facility
  • Jackson, MS
  • NPI 1689664765

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Laurel, LLC

  dba Laurelwood Community Living Center

  • Skilled Nursing Facility
  • Laurel, MS
  • NPI 1326038092

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership
• CLC of Liberty, LLC

  dba Liberty Community Living Center

  • Skilled Nursing Facility
  • Liberty, MS
  • NPI 1912997685

  Community Eldercare Services, LLC, Community Living Centers, LLC

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mancel Wayne Wakham, DO

  • Family Medicine Physician
  • Harriman, TN
  • NPI 1073568218
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Michael Todd Montgomery, DO

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1336330232

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495756800000",
    "number": "1235676156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3667",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033667",
            "telephone_number": "662-680-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 PATTON LN",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377488618",
            "telephone_number": "865-354-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLC OF HARRIMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-05-26",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "662-680-3148",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "212",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q027303",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q027302",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua David Clark-Fuqua, MD
• Katlyn Bailey Clark-Fuqua, MD
• Douglas Marley Clark, PAC
• Clary Foote MD P.C.
• Clary Foote MD PC
• Deborah L Clem, D.PH.
• Hannah Elizabeth Cox Cline, MD
• Angela Nicole Coffey
• Leonard Michael Copertino, M.D.
• Shelbey Blake Corbin, PHARMD

• Skilled Nursing Facility in Harriman, TN
• Providers in Harriman, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.