Provider Demographics
NPI:1073600292
Name:SPECIAL CARE AGENCY
Entity Type:Organization
Organization Name:SPECIAL CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HELLEN
Authorized Official - Last Name:CALLOWAY-BUNCH-NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:865-531-8522
Mailing Address - Street 1:1532 LA PALOMA DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-1440
Mailing Address - Country:US
Mailing Address - Phone:865-531-8522
Mailing Address - Fax:865-531-8522
Practice Address - Street 1:1532 LA PALOMA DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-1440
Practice Address - Country:US
Practice Address - Phone:865-531-8522
Practice Address - Fax:865-531-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP 438-026-9900251E00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251E00000XAgenciesHome Health
Not Answered376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherHOME HEALTH CARE