Provider Demographics
NPI:1568105765
Name:DEDICATED CARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:DEDICATED CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:CATRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-279-7723
Mailing Address - Street 1:6520 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3808
Mailing Address - Country:US
Mailing Address - Phone:901-825-1341
Mailing Address - Fax:901-529-7135
Practice Address - Street 1:6520 STAGE RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3808
Practice Address - Country:US
Practice Address - Phone:901-825-1341
Practice Address - Fax:901-529-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health