Provider Demographics
NPI:1386041218
Name:WILLIAM BREWER ENTERPRISES
Entity Type:Organization
Organization Name:WILLIAM BREWER ENTERPRISES
Other - Org Name:ACTIKARE RESPONSIVE IN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-789-2172
Mailing Address - Street 1:10805 DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:FARRAGUT
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1814
Mailing Address - Country:US
Mailing Address - Phone:865-789-2172
Mailing Address - Fax:865-966-6302
Practice Address - Street 1:10805 DUNDEE RD
Practice Address - Street 2:
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-1814
Practice Address - Country:US
Practice Address - Phone:865-789-2172
Practice Address - Fax:865-966-6302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000014344253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445824Medicaid
TNT000469Medicaid