Provider Demographics
NPI:1639931710
Name:CLEAR CARE HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:CLEAR CARE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS-CRISP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-337-6165
Mailing Address - Street 1:3312 N HIGHLAND AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3469
Mailing Address - Country:US
Mailing Address - Phone:731-337-6165
Mailing Address - Fax:731-300-3117
Practice Address - Street 1:3312 N HIGHLAND AVE STE 7
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3469
Practice Address - Country:US
Practice Address - Phone:731-337-6165
Practice Address - Fax:731-300-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care