Provider Demographics
NPI:1659062032
Name:MIDDLE TN HOME HEALTH LLC.
Entity Type:Organization
Organization Name:MIDDLE TN HOME HEALTH LLC.
Other - Org Name:COMFORCARE HOME CARE CLARKSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JODWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-568-0778
Mailing Address - Street 1:1808 MEMORIAL CIR STE D
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4528
Mailing Address - Country:US
Mailing Address - Phone:615-931-1875
Mailing Address - Fax:
Practice Address - Street 1:1808 MEMORIAL CIR STE D
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4528
Practice Address - Country:US
Practice Address - Phone:615-931-1875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health