Provider Demographics
NPI:1982857322
Name:SPECIAL NEEDS HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:SPECIAL NEEDS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LEANGEL
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-920-8425
Mailing Address - Street 1:1860 WILMA RUDOLPH BLVD # 103B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6750
Mailing Address - Country:US
Mailing Address - Phone:931-920-8425
Mailing Address - Fax:931-378-7016
Practice Address - Street 1:1860 WILMA RUDOLPH BLVD # 103B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6750
Practice Address - Country:US
Practice Address - Phone:931-920-8425
Practice Address - Fax:931-378-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15878251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health