NPI 1013492743
Countryside Tn Opco LLC
Practice location
- Address
- 3051 Buffalo Rd, Lawrenceburg, TN 38464-6189
- Phone
- (931) 762-7518
- Mailing address
- 2071 Flatbush Ave STE 12, Brooklyn, NY 11234-4340
Authorised official
- Name
- David Herskowitz
- Title
- Ceo
- Phone
- (212) 444-1991
Registered specialties
Skilled Nursing Facility
Primary
Registry record
- NPI
- 1013492743
- Entity type
- Organization
- NPI issued
- 28 Sep 2018
- Record last updated
- 8 Feb 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.