Provider Demographics
NPI:1649959800
Name:GOOD SHEPHERD HOME CARE GROUP LLC
Entity type:Organization
Organization Name:GOOD SHEPHERD HOME CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:HERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-300-2848
Mailing Address - Street 1:435 METROPLEX DR STE 5
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3109
Mailing Address - Country:US
Mailing Address - Phone:615-300-2848
Mailing Address - Fax:
Practice Address - Street 1:435 METROPLEX DR STE 5
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3109
Practice Address - Country:US
Practice Address - Phone:615-300-2848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, ChildGroup - Multi-Specialty
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty