Provider Demographics
NPI:1477301497
Name:PHILLIPS RESIDENTIAL SERVICES
Entity type:Organization
Organization Name:PHILLIPS RESIDENTIAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:PHILLIPS
Authorized Official - Last Name:DOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-720-7384
Mailing Address - Street 1:726 SHADY GROVE DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-7629
Mailing Address - Country:US
Mailing Address - Phone:615-720-7384
Mailing Address - Fax:
Practice Address - Street 1:150 UPTOWN SQ STE C
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0581
Practice Address - Country:US
Practice Address - Phone:615-720-7384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:86-278213
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-07
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty