Provider Demographics
NPI:1275825036
Name:ABC INC DBA HOME INSTEAD SENIOR CARE
Entity Type:Organization
Organization Name:ABC INC DBA HOME INSTEAD SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-523-1300
Mailing Address - Street 1:PO BOX 11206
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-1206
Mailing Address - Country:US
Mailing Address - Phone:865-523-1300
Mailing Address - Fax:865-558-8170
Practice Address - Street 1:4635 CHAMBLISS AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5119
Practice Address - Country:US
Practice Address - Phone:865-523-1300
Practice Address - Fax:865-558-8170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000008263253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care