- Enrollment id
- O20030708000026
- Enrollment state
- TN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1871605287
- Multiple npi flag
- N
- Ccn
- 445459
- Associate id
- 2062322902
- Organization name
- HANCOCK MANOR, LLC
- Doing business as name
- HANCOCK MANOR NURSING HOME
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- HANCOCK MANOR NURSING HOME
- Affiliation entity name
- TWIN RIVERS HEALTH & REHABILITATION
- Affiliation entity id
- 532
- Address line 1
- 1423 MAIN ST
- City
- SNEEDVILLE
- State
- TN
- Zip code
- 378693654