Clc of Humboldt, LLC

NPI #1275523854 in Humboldt, Tennessee

Provider Information

NPI Number
1275523854
Entity Type
Organization
Organization Name
Clc of Humboldt, LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 25, 2005
Last Updated
Jan 28, 2008

Practice Location

Address
2400 E MITCHELL ST
ZIP Code
38343-3036
Phone
(731) 784-5183

Authorized Official

Name
MR. DOUGLAS M. WRIGHT JR.
Title
MANAGING MEMBER
Phone
(662) 680-3148

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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