Provider Demographics
NPI:1578528923
Name:VIP HOME NURSING & REHABILITATION SERVICE, LLC
Entity Type:Organization
Organization Name:VIP HOME NURSING & REHABILITATION SERVICE, LLC
Other - Org Name:CAREALL HOME CARE SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-781-0666
Mailing Address - Street 1:4015 TRAVIS DR
Mailing Address - Street 2:STE 102
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3758
Mailing Address - Country:US
Mailing Address - Phone:615-835-4445
Mailing Address - Fax:615-835-5545
Practice Address - Street 1:4015 TRAVIS DR
Practice Address - Street 2:STE 102
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3758
Practice Address - Country:US
Practice Address - Phone:615-835-4445
Practice Address - Fax:615-835-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000295251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
01-035025OtherAMERIGROUP COMMUNITY CARE
TN447425Medicaid
TN4167596OtherBC/BS OF TENNESSEE
A3708704OtherAMERICHOICE
TN447425Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER