Sweetwater Home for Seniors

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ACL000000291 Issued in TN

Legal business name

SWEETWATER HOME FOR SENIORS

Practice address

245 Butler Dr
Sweetwater, TN 37874-1441

Phone

(423) 337-9742

Fax

(423) 836-9095

NPI assigned

Oct 1, 2010

Last updated

Oct 1, 2010By 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. Samuel Alexander Beverley III, MBA

Title

Administrator

Phone

(423) 337-9742

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1467761841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 BUTLER DR",
            "city": "SWEETWATER",
            "state": "TN",
            "postal_code": "378741441",
            "telephone_number": "423-337-9742",
            "fax_number": "423-836-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 BUTLER DR",
            "city": "SWEETWATER",
            "state": "TN",
            "postal_code": "378741441",
            "telephone_number": "423-337-9742",
            "fax_number": "423-836-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETWATER HOME FOR SENIORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "BEVERLEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-337-9742",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TN",
            "license": "ACL000000291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H4451113",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sweetwater Chiropractic LLC
• Sweetwater Endodontics PLLC
• Sweetwater Family Dental, PLLC
• Sweetwater Family Eyecare PLLC (Foster Family Eyecare)
• Sweetwater Family Medicine Inc
• Sweetwater Hospital Association (Sweetwater Hospital Association Rural Health Clinic)
• Sweetwater Hospital Association
• Sweetwater Hospital Association (Sweetwater Physician Group)
• Sweetwater Hospital Association (Sweetwater Hospital Crna Group)
• Sweetwater Hospital Association (Sweetwater Home Health Agency)

• Assisted Living Facility in Sweetwater, TN
• Providers in Sweetwater, 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 Oct 1, 2010; 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.