Imperial Manor Convalescent Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000053 Issued in TN

Legal business name

IMPERIAL MANOR CONVALESCENT CENTER LLC

Doing business as

Imperial Gardens Health and Rehabilitation

Practice address

306 W Due West Ave
Madison, TN 37115-4511

Phone

(615) 865-5001

Fax

(615) 865-0321

NPI assigned

Jan 13, 2006

Last updated

Nov 4, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

VANGUARD HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Kirk F Hebert

Title

Secretary

Phone

(615) 250-7100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Imperial Gardens Health and Rehabilitation Doing business as

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1750360152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CADILLAC DR",
            "address_2": "SUITE 310",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275080",
            "telephone_number": "615-250-7100",
            "fax_number": "615-250-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W DUE WEST AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154511",
            "telephone_number": "615-865-5001",
            "fax_number": "615-865-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL MANOR CONVALESCENT CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VANGUARD HEALTHCARE, LLC",
        "enumeration_date": "2006-01-13",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-250-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440514",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445047",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Gardens Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Madison, TN
• Providers in Madison, 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 Nov 4, 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.