Holston Manor Snf Operations LLC
NPI 1669136123ActiveOrganization· Skilled Nursing Facility· Kingsport, TN
Skilled Nursing Facility in Kingsport, Tennessee, registered in NPPES in October 2021. The authorized official on file is Menucha Goodman, Authorized Official. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1669136123 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 29, 2021 |
| Last updated in NPPES | Feb 4, 2026 |
| Certified by provider | Feb 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
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) |
|---|
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