CLC OF WHITEHAVEN, LLC (NPI# 1407846942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407846942 |
| Entity Type | Organization |
| Organization Name | CLC OF WHITEHAVEN, LLC |
| Other Organization Name | WHITEHAVEN COMMUNITY LIVING CENTER |
| Practice Address |
1076 Chambliss Rd Memphis TN 38116-6381 |
| Mailing Address |
Po Box 161000 Memphis TN 38186-1000 |
| Practice Telephone | 9013968470 |
| Practice Fax Number | 9013980271 |
| Mailing Telephone | 9013968470 |
| Mailing Fax Number | 9013980271 |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2008-01-28 |
| Authorized Official Name | MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER) |
| Authorized Official Telephone | 6626803148 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0000000258 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 744-0205 | 05 |
| Other Name | Type Code |
|---|---|
| Whitehaven Community Living Center | Doing Business As Name - Organization |
| Street Address |
1076 CHAMBLISS RD |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38116-6381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831526904 | Paul S Brown | Occupational Therapy Assistant | 1076 Chambliss Rd, Memphis, TN 38116-6381 | 2013-10-03 |
| 1508013939 | Georgia Diane Stone | Occupational Therapy Assistant | 1076 Chambliss Rd, Memphis, TN 38116-6381 | 2008-08-27 |
| 1043467467 | Stacy Mckeegan | Community Health Worker | 1076 Chambliss Rd, Memphis, TN 38116-6381 | 2008-08-27 |
| 1386890085 | Angela Larose Douglas | Community Health Worker | 1076 Chambliss Rd, Memphis, TN 38116-6381 | 2008-08-13 |
| 1508022054 | Thomas H Lawrence Iv | Nursing Facility/Intermediate Care Facility | 1076 Chambliss Rd, Memphis, TN 38116-6381 | 2008-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265296 | Heart To Home Healthcare Services Inc | In Home Supportive Care | 3385 Airways Boulevard, Suite 233, Memphis, TN 38116 | 2020-05-01 |
| 1912526088 | Sanitas Medical Center of Tennessee PC | Family Medicine | 1200 E Raines Rd, Suite 101, Memphis, TN 38116 | 2020-04-09 |
| 1548896715 | Annie M Griffin | In Home Supportive Care | 1014 Cullenwood Drive, Memphis, TN 38116 | 2020-03-19 |
| 1144865700 | Johnnie Mary Lawson | Technician | 5152 Schutt Rd, Memphis, TN 38116 | 2019-11-07 |
| 1013475193 | Peace of Mind Adult Daycare Services, LLC | Clinic/Center | 4283 Millbranch Rd, Memphis, TN 38116 | 2019-03-07 |
| 1023580909 | April Nicole Mallory | Home Health Aide | 3225 Kirby Whitten Space 12, Suite 201, Memphis, TN 38116 | 2018-12-17 |
| 1437641941 | Trinity Community Coalition Outreach | Clinic/Center | 4466 Elvis Presley Blvd Ste 260, Memphis, TN 38116 | 2018-05-31 |
| 1851848386 | Veronica Hudson | Speech-Language Pathologist | 1036 Chambliss Rd, Memphis, TN 38116 | 2016-09-01 |
| 1710434378 | Chloe Bunch | Speech-Language Pathologist | 1076 Chamblee Road, Memphis, TN 38116 | 2016-09-01 |
| 1033516109 | Comprehensive Pediatrics | Pediatrics | 4250 Faronia Road, Suite 3, Memphis, TN 38116 | 2014-12-04 |
| Find all providers in zip 38116 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881820702 | Lp Memphis II, LLC | Skilled Nursing Facility | 6007 Park Ave, Memphis, TN 38119-5200 | 2009-06-05 |
| 1407071616 | Psalms, Inc | Skilled Nursing Facility | 3535 Kirby Rd, Memphis, TN 38115-3721 | 2007-04-14 |
| 1457404386 | Zues Leasing LLC | Skilled Nursing Facility | 1415 N. 18th Street, Memphis, TX 79245 | 2007-01-22 |
| 1821161803 | Quince Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 6733 Quince Rd, Memphis, TN 38119-8602 | 2006-11-16 |
| 1295811255 | Scotland County Nursing Home District | Skilled Nursing Facility | 434 E Sigler Avenue, Memphis, MO 63555-1714 | 2006-10-31 |
| 1770684342 | Mid-south Health Services, LLC | Skilled Nursing Facility | 3030 Walnut Grove Rd, Memphis, TN 38111-3508 | 2006-09-26 |
| 1063445914 | Graceland Nursing Center, LLC | Skilled Nursing Facility | 1250 Farrow Rd, Memphis, TN 38116-7116 | 2006-07-07 |
| 1760411607 | Allenbrooke Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 3933 Allenbrooke Cv, Memphis, TN 38118-1866 | 2006-07-02 |
| 1689646150 | Fmsc Memphis Operating Company LLC | Skilled Nursing Facility | 2491 Joy Ln, Memphis, TN 38114-6088 | 2006-02-07 |
| 1417936840 | Vanguard of Memphis, LLC | Skilled Nursing Facility | 131 N Tucker St, Memphis, TN 38104 | 2006-01-13 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.