Provider Demographics
NPI:1245701150
Name:GOOD SHEPHERD ACQUISITION LLC
Entity type:Organization
Organization Name:GOOD SHEPHERD ACQUISITION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDIN-MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-365-4424
Mailing Address - Street 1:1101 KERMIT DR STE 204
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-5102
Mailing Address - Country:US
Mailing Address - Phone:615-365-4424
Mailing Address - Fax:615-365-7897
Practice Address - Street 1:3280 NC HIGHWAY 69, STE. 11-A
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-6953
Practice Address - Country:US
Practice Address - Phone:828-389-8106
Practice Address - Fax:828-389-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health