Black Wolf Healthcare LLC
NPI 1447085782ActiveOrganization· Skilled Nursing Facility· Decaturville, TN
Skilled Nursing Facility in Decaturville, Tennessee, registered in NPPES in September 2024. The authorized official on file is Soon Burnam, Treasurer. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1447085782 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 5, 2024 |
| Last updated in NPPES | Nov 14, 2025 |
| Certified by provider | Nov 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
| Nursing Facility/Intermediate Care Facility | 313M00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (TN) |
|---|
Other Skilled Nursing Facility providers in Decaturville
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