Tri-Age Adventures, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

168 Issued in TN

Legal business name

TRI-AGE ADVENTURES, INC.

Doing business as

Knollwood Manor
Knollwood Manor/The White House Assisted Living

Practice address

405 Times Ave
Lafayette, TN 37083-1247

Phone

(615) 666-3170

Fax

(615) 666-9146

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Linda Ruth Austin

Title

Owner/Administrator

Phone

(615) 666-3170

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Knollwood Manor Doing business as
• Knollwood Manor/The White House Assisted Living Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Skilled nursing facility certification: CCN 445410

Legal name

TRI-AGE ADVENTURES, INC.

Doing business as

KNOLLWOOD MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Mar 12, 1998

Last certification

Jul 14, 2022

Beds

49

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Nov 2, 1993 in TN

Enrollment address

405 Times Avenue
Lafayette, TN 37083-1247

Nursing home name

KNOLLWOOD MANOR

Listed as

Knollwood ManorCCN 445410 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 12, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4939.5 residents per day on average

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 2

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hanna C Ilia, MD

  • Family Medicine Physician
  • Lafayette, TN
  • NPI 1205826526
  NPD (past)

Affiliated clinicians 2

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

• Hanna C Ilia, MD

  • Family Medicine Physician
  • Lafayette, TN
  • NPI 1205826526

  Nursing home

  Care Compare affiliation
• Olufemi O Odunusi, M.D.

  • Internal Medicine Physician
  • Lafayette, TN
  • NPI 1861541351

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1699872879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 TIMES AVE",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370831247",
            "telephone_number": "615-666-3170",
            "fax_number": "615-666-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 TIMES AVE",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370831247",
            "telephone_number": "615-666-3170",
            "fax_number": "615-666-9146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Red Boiling Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "TN",
            "postal_code": "370831755",
            "country_code": "US",
            "telephone_number": "615-666-5566",
            "fax_number": "615-666-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRI-AGE ADVENTURES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "615-666-3170",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445410",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440570",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knollwood Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Knollwood Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Knollwood Manor/The White House Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Lafayette, TN
• Providers in Lafayette, 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 Jun 21, 2022; 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.