Provider Demographics
NPI:1235506866
Name:PRIORITY SENIOR CARE LLC
Entity Type:Organization
Organization Name:PRIORITY SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:NAKUME
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-635-6668
Mailing Address - Street 1:300 WILLIE D DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-3961
Mailing Address - Country:US
Mailing Address - Phone:865-635-6668
Mailing Address - Fax:
Practice Address - Street 1:300 WILLIE D DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-3961
Practice Address - Country:US
Practice Address - Phone:865-635-6668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care