Provider Demographics
NPI:1629219399
Name:RELIABLE SENIOR CARE
Entity Type:Organization
Organization Name:RELIABLE SENIOR CARE
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-831-2358
Mailing Address - Street 1:PO BOX 100591
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37224-0591
Mailing Address - Country:US
Mailing Address - Phone:615-831-2358
Mailing Address - Fax:
Practice Address - Street 1:2803B FOSTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-5324
Practice Address - Country:US
Practice Address - Phone:615-831-2358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000015549251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445466Medicaid