Provider Demographics
NPI:1740738269
Name:365 IN HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:365 IN HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PEACOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-838-3672
Mailing Address - Street 1:1633 AARONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-4236
Mailing Address - Country:US
Mailing Address - Phone:615-838-3672
Mailing Address - Fax:615-847-4613
Practice Address - Street 1:1633 AARONWOOD DR
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-4236
Practice Address - Country:US
Practice Address - Phone:615-838-3672
Practice Address - Fax:615-847-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000018965253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care