Provider Demographics
NPI:1649765553
Name:TUCKER'S HOUSE
Entity Type:Organization
Organization Name:TUCKER'S HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSANBALM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-504-3185
Mailing Address - Street 1:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174
Mailing Address - Country:US
Mailing Address - Phone:615-310-5224
Mailing Address - Fax:615-777-3173
Practice Address - Street 1:201 BEASLEY DRIVE UNIT G
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:615-310-5224
Practice Address - Fax:615-777-3173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty