Basic Information
| Provider Information | |||||||||
| NPI: | 1740247550 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTWOOD HEALTH CARE AND REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O, BOX 10 | ||||||||
| Address2: | |||||||||
| City: | PARSONS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383630010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7318476343 | ||||||||
| FaxNumber: | 7318474200 | ||||||||
| Practice Location | |||||||||
| Address1: | 524 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DECATURVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 38329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7318523591 | ||||||||
| FaxNumber: | 7318522283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | BRADLEY | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 6155958383 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AMERICAN HEALTH COMPANIES, LLC | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 05/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | 0070 | TN | N | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility | 314000000X | 0000000070 | TN | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 744-0551 | 05 | TN | MEDICAID |