Provider Demographics
NPI:1093077836
Name:HEALTH CARE INITIATIVE OF TN, INC
Entity Type:Organization
Organization Name:HEALTH CARE INITIATIVE OF TN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:N
Authorized Official - Last Name:WACHIRA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:865-548-5805
Mailing Address - Street 1:4026 LARIGO DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37914-3161
Mailing Address - Country:US
Mailing Address - Phone:865-548-5805
Mailing Address - Fax:
Practice Address - Street 1:4026 LARIGO DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-3161
Practice Address - Country:US
Practice Address - Phone:865-548-5805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000010764253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care