BAILEY PARK COMMUNITY LIVING CENTER
NPI 1275523854
Skilled Nursing Facility in Humboldt, TN

Active since October 25, 2005CLIA 44D0858592 · Microscopy
2400 E MITCHELL ST, HUMBOLDT, TN 38343(731) 784-5183(731) 784-1562 Get Directions Write a Review

NPPES record last updated: January 28, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bailey Park Community Living Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAILEY PARK COMMUNITY LIVING CENTER (NPI 1275523854) is a healthcare organization registered as a skilled nursing facility in Humboldt, Tennessee and active in the NPI registry since October 2005. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Douglas M. Wright, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1275523854
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCLC OF HUMBOLDT, LLC
Location Address2400 E MITCHELL STHumboldt, TN 38343-3036
Mailing Address2400 E Mitchell St, P.o. Box 620Humboldt, TN 38343-3036 · (731) 784-5183 · Fax (731) 784-1562
Fax(731) 784-1562
Organization SubpartNo
Authorized OfficialDouglas M. WrightManaging Member · (662) 680-3148
Enumeration DateOctober 25, 2005
Last NPPES UpdateJanuary 28, 2008
NPI 1275523854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in TN · 0000000088
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
2400 E MITCHELL ST, Humboldt, TN 38343

Other Names 1

Doing Business AsBailey Park Community Living Center

Other Identifiers 2

Medicare ID-Type Unspecified44-5339TN
Medicaid744-0208TN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 44D0858592

Clc Humboldt LLC Dba Bailey Park Community Living Center · Humboldt, TN
Active · expires Aug 31, 2026
CLIA Number44D0858592
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTrudy C. Lowe
Laboratory Phone(731) 784-5183
Laboratory LocationClc Humboldt LLC Dba Bailey Park Community Living Center2400 Mitchell Street, Humboldt, TN 38343
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
2400 E MITCHELL ST
HUMBOLDT, TN 38343
Physical Therapy Assistant
2400 E MITCHELL ST
HUMBOLDT, TN 38343
Occupational Therapy Assistant
2400 E MITCHELL ST
HUMBOLDT, TN 38343
Occupational Therapist
2400 E MITCHELL ST
HUMBOLDT, TN 38343
Occupational Therapist
2400 E MITCHELL ST
HUMBOLDT, TN 38343
Occupational Therapist
2400 E MITCHELL ST
HUMBOLDT, TN 38343
Speech-Language Pathologist
2400 E MITCHELL ST
HUMBOLDT, TN 38343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clc Of Humboldt, LLC's NPI number?

The NPI number for Clc Of Humboldt, LLC is 1275523854. It was assigned to this organization in the NPPES registry on October 25, 2005. The provider is doing business as Bailey Park Community Living Center.

Where is Clc Of Humboldt, LLC located?

Clc Of Humboldt, LLC is located at 2400 E Mitchell St, Humboldt, TN 38343. The listed phone number is (731) 784-5183.

What is Clc Of Humboldt, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Clc Of Humboldt, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 44D0858592) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clc Of Humboldt, LLC was last updated on January 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.