- Enrollment id
- O20070226000621
- Enrollment state
- TN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1356413843
- Multiple npi flag
- N
- Ccn
- 445242
- Associate id
- 5698877421
- Organization name
- BLOUNTS OPERATOR LLC
- Doing business as name
- GREYSTONE HEALTH CARE CENTER
- Incorporation date
- 2006-11-02
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- GREYSTONE HEALTH CARE CENTER
- Affiliation entity name
- PRESTIGE ADMINISTRATIVE SERVICES
- Affiliation entity id
- 416
- Address line 1
- 181 DUNLAP RD
- City
- BLOUNTVILLE
- State
- TN
- Zip code
- 376176333