Provider Demographics
NPI:1710665690
Name:GREATER KNOXVILLE SENIOR HOME CARE LLC
Entity Type:Organization
Organization Name:GREATER KNOXVILLE SENIOR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-889-0608
Mailing Address - Street 1:524 GLEN ABBEY BLVD
Mailing Address - Street 2:
Mailing Address - City:FARRAGUT
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3941
Mailing Address - Country:US
Mailing Address - Phone:919-889-0608
Mailing Address - Fax:
Practice Address - Street 1:9041 EXECUTIVE PARK DR STE 250
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4657
Practice Address - Country:US
Practice Address - Phone:919-889-0608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care