Provider Demographics
NPI:1508257080
Name:COMPLETE HOME CARE SERVICES OF TENNESSEE
Entity Type:Organization
Organization Name:COMPLETE HOME CARE SERVICES OF TENNESSEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CONSUELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-969-0551
Mailing Address - Street 1:2504 CAYER LN STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-7384
Mailing Address - Country:US
Mailing Address - Phone:931-451-7777
Mailing Address - Fax:
Practice Address - Street 1:2504 CAYER LN STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-7384
Practice Address - Country:US
Practice Address - Phone:931-451-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TN50263311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home