OrganizationActive
Abundant Christian Living Community LLC
NPI 1902491178 · Skilled Nursing Facility · Johnson City, TN
Provider details
- NPI number
- 1902491178
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jimmy Lewis, Chief Manager(423) 975-5455
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Assisted Living Facility310400000X
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Practice location
2012 Sherwood Dr
Johnson City, TN 37601-3238
Phone: (423) 232-8200
Fax: (423) 232-8240
Approximate (ZIP-level) locationGet directions
Mailing address
2020 Northpark Dr Ste 2d
Johnson City, TN 37604-3127
Registry dates
- Enumerated
- 2021-03-09
- Last updated
- 2021-03-10
- Certified
- 2021-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.