Provider Demographics
NPI:1033587761
Name:AT HOME- HOMECARE SERVICES
Entity Type:Organization
Organization Name:AT HOME- HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:615-617-3586
Mailing Address - Street 1:354 DEJARNETTE LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-9093
Mailing Address - Country:US
Mailing Address - Phone:615-617-3586
Mailing Address - Fax:
Practice Address - Street 1:354 DEJARNETTE LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-9093
Practice Address - Country:US
Practice Address - Phone:615-617-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care