Provider Demographics
NPI:1467739979
Name:MAHOGANY SENIOR CARE
Entity Type:Organization
Organization Name:MAHOGANY SENIOR CARE
Other - Org Name:MAHOGANY HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GIAVONNI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-669-4548
Mailing Address - Street 1:1229 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-5438
Mailing Address - Country:US
Mailing Address - Phone:615-669-4548
Mailing Address - Fax:
Practice Address - Street 1:1229 N 2ND ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-5438
Practice Address - Country:US
Practice Address - Phone:615-669-4548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-11
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization