Provider Demographics
NPI:1013588656
Name:BLUE RIDGE CARE SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:BLUE RIDGE CARE SOLUTIONS, LLC.
Other - Org Name:SENTINEL HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-900-8499
Mailing Address - Street 1:3107 W MARKET ST STE 1
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-9348
Mailing Address - Country:US
Mailing Address - Phone:423-900-8499
Mailing Address - Fax:866-404-0950
Practice Address - Street 1:106 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4501
Practice Address - Country:US
Practice Address - Phone:423-900-8499
Practice Address - Fax:866-404-0950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNL000000027512OtherPSSA LICENSE