Provider Demographics
NPI:1437151263
Name:CLINCH RIVER HOME HEALTH, INC
Entity Type:Organization
Organization Name:CLINCH RIVER HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:FEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:865-457-4263
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37717-0056
Mailing Address - Country:US
Mailing Address - Phone:865-457-4263
Mailing Address - Fax:865-457-9415
Practice Address - Street 1:401 SULPHUR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-2222
Practice Address - Country:US
Practice Address - Phone:865-457-4263
Practice Address - Fax:865-457-9415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN447405Medicare ID - Type UnspecifiedHOME HEALTH