Provider Demographics
NPI:1114411329
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:MS
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:PO BOX 6175
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-6175
Mailing Address - Country:US
Mailing Address - Phone:423-900-8499
Mailing Address - Fax:866-404-0950
Practice Address - Street 1:709 MED TECH PKWY STE 2
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2643
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:2018-06-20
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000021323253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNL000000027512OtherPSSA LICENSE