Southern Manor Living Centers, LLC
NPI #1619274644 in Fayetteville, Tennessee
Provider Information
- NPI Number
- 1619274644
- Entity Type
- Organization
- Organization Name
- Southern Manor Living Centers, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Feb 28, 2011
- Last Updated
- Feb 28, 2011
Practice Location
- Address
- 115 MEDICAL CENTER BLVD
- City
- Fayetteville
- State
- Tennessee
- ZIP Code
- 37334-2689
- Phone
- (931) 433-5000
Authorized Official
- Name
- CHERYL PENDERGRASS, MSN
- Title
- EXECUTIVE DIRECTOR
- Phone
- (931) 433-5000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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