Provider Demographics
NPI:1760801500
Name:STAY AT HOME SENIOR CARE
Entity Type:Organization
Organization Name:STAY AT HOME SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:TAQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-426-9097
Mailing Address - Street 1:307 E PALESTINE AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5338
Mailing Address - Country:US
Mailing Address - Phone:615-970-9197
Mailing Address - Fax:
Practice Address - Street 1:307 E PALESTINE AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5338
Practice Address - Country:US
Practice Address - Phone:615-970-9197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care