Provider Demographics
NPI:1578134714
Name:HOME NEEDS HOME HEALTH
Entity Type:Organization
Organization Name:HOME NEEDS HOME HEALTH
Other - Org Name:HOME NEEDS HOME HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHENELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED NURSE
Authorized Official - Phone:615-972-5960
Mailing Address - Street 1:712 ROMAN DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-3516
Mailing Address - Country:US
Mailing Address - Phone:615-972-5960
Mailing Address - Fax:
Practice Address - Street 1:712 ROMAN DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-3516
Practice Address - Country:US
Practice Address - Phone:615-972-5960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health