Provider Demographics
NPI:1912558099
Name:CARDEA HOMECARE, LLC
Entity Type:Organization
Organization Name:CARDEA HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-804-2496
Mailing Address - Street 1:1368 REYNARD DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2546
Mailing Address - Country:US
Mailing Address - Phone:865-804-2496
Mailing Address - Fax:
Practice Address - Street 1:1368 REYNARD DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2546
Practice Address - Country:US
Practice Address - Phone:865-804-2496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care