Provider Demographics
NPI:1356006779
Name:TENNESSEE MEDICAL HOME HEALTHCARE SERVICES LIMITED LIABILITY CORPORATI
Entity Type:Organization
Organization Name:TENNESSEE MEDICAL HOME HEALTHCARE SERVICES LIMITED LIABILITY CORPORATI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:ALONZO
Authorized Official - Last Name:TINDALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:931-551-0739
Mailing Address - Street 1:217 IVY BEND CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6860
Mailing Address - Country:US
Mailing Address - Phone:931-551-0739
Mailing Address - Fax:
Practice Address - Street 1:217 IVY BEND CIR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6860
Practice Address - Country:US
Practice Address - Phone:931-368-9020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty