Provider Demographics
NPI:1043597271
Name:KIDD SENIOR CARE SERVICE, INC.
Entity Type:Organization
Organization Name:KIDD SENIOR CARE SERVICE, INC.
Other - Org Name:ALWAYS BEST CARE SENIOR SERVICES OF NASHVILLE WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-319-1472
Mailing Address - Street 1:750 OLD HICKORY BLVD
Mailing Address - Street 2:BLDG. 2, SUITE 150
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4528
Mailing Address - Country:US
Mailing Address - Phone:615-371-6101
Mailing Address - Fax:615-373-1582
Practice Address - Street 1:750 OLD HICKORY BLVD
Practice Address - Street 2:BLDG. 2, SUITE 150
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4528
Practice Address - Country:US
Practice Address - Phone:615-371-6101
Practice Address - Fax:615-373-1582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000008486253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445567Medicaid