BOLIVAR ASSISTED CARE LIVING, LLC (NPI# 1982838660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982838660 |
| Entity Type | Organization |
| Organization Name | BOLIVAR ASSISTED CARE LIVING, LLC |
| Practice Address |
631 Nuckolls Rd Bolivar TN 38008-1599 |
| Mailing Address |
15 S Bells St Suite #3 Alamo TN 38001-1778 |
| Practice Telephone | 7316583313 |
| Practice Fax Number | 7316589889 |
| Mailing Telephone | 7316964670 |
| Mailing Fax Number | 7316964672 |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2009-05-08 |
| Authorized Official Name | CRAIG BRADFORD LAMAN (MEMBER) |
| Authorized Official Telephone | 7316964670 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | ACL00000000182 | TN | Nursing & Custodial Care Facilities |
| Street Address |
631 NUCKOLLS RD |
| City | BOLIVAR |
| State | TN |
| Zip Code | 38008-1599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
| 1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
| 1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
| 1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
| 1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
| 1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
| 1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| Find all providers in zip 38008 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780878090 | Lighthouse of Hope, LLC | Assisted Living Facility | 342 E Broadway St, Bolivar, MO 65613-1680 | 2007-08-29 |
| 1689791311 | Citizens Memorial Health Care Foundation | Assisted Living Facility | 1120 N Butterfield Rd, Bolivar, MO 65613-1000 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061141 | Morning Pointe Assisted Living | Assisted Living Facility | 324 Mount Bethel Rd, Greeneville, TN 37745-6346 | 2020-10-23 |
| 1467069807 | Goodlettsville Al Mc Care Properties, LLC | Assisted Living Facility | 322 Northcreek Blvd, Goodlettsville, TN 37072-1998 | 2020-09-29 |
| 1417564410 | Lily Healthcare Service | Assisted Living Facility | 4290 Ridgestone Dr Apt 5, Memphis, TN 38128-1837 | 2020-09-24 |
| 1871107482 | Springfield Residential, LLC | Assisted Living Facility | 2530 South Main Street, Springfield, TN 37172 | 2020-09-01 |
| 1275161200 | Mcclain Properties, LLC | Assisted Living Facility | 1320 Bellshire Terrace Dr, Nashville, TN 37207-1734 | 2020-03-27 |
| 1336779248 | Meadow View Senior Living | Assisted Living Facility | 111 Acuff Ln, Clinton, TN 37716-6892 | 2020-01-20 |
| 1104461383 | Denise Senior Living | Assisted Living Facility | 1016 Charlie Daniels Pkwy, Mt Juliet, TN 37122-3064 | 2019-11-12 |
| 1164070454 | Heritage At S Peters Inc | Assisted Living Facility | 273 S Peters Rd, Knoxville, TN 37923-5204 | 2019-08-29 |
| 1316595085 | Snh Tenn Tenant LLC | Assisted Living Facility | 1010 E Spring St, Cookeville, TN 38501-3651 | 2019-08-27 |
| 1427601327 | Pinnacle Assisted Living | Assisted Living Facility | 10520 Waterville Ln, Knoxville, TN 37932-3754 | 2019-07-19 |
| Find all providers with the same taxonomy | ||||
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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.