Provider Demographics
NPI:1770818718
Name:BONDS CARE HOME, INC #2
Entity Type:Organization
Organization Name:BONDS CARE HOME, INC #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-384-9205
Mailing Address - Street 1:3805 RIDGEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-1948
Mailing Address - Country:US
Mailing Address - Phone:901-384-9205
Mailing Address - Fax:901-384-9797
Practice Address - Street 1:3482 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-6118
Practice Address - Country:US
Practice Address - Phone:901-384-9205
Practice Address - Fax:901-384-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000003698253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care