Provider Demographics
NPI:1407810419
Name:FRIENDSHIP HOME HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:FRIENDSHIP HOME HEALTH AGENCY, LLC
Other - Org Name:FRIENDSHIP HOME HEALTH AGENCY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MORGAN FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-365-4424
Mailing Address - Street 1:1101 KERMIT DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217
Mailing Address - Country:US
Mailing Address - Phone:615-365-4424
Mailing Address - Fax:615-365-0998
Practice Address - Street 1:1101 KERMIT DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3721
Practice Address - Country:US
Practice Address - Phone:615-365-4424
Practice Address - Fax:615-365-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000323251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3035083Medicaid
447578Medicare ID - Type Unspecified