Provider Demographics
NPI:1720511215
Name:NBM HOME CARE SERVICES
Entity Type:Organization
Organization Name:NBM HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-286-1366
Mailing Address - Street 1:215 HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-4938
Mailing Address - Country:US
Mailing Address - Phone:731-286-1366
Mailing Address - Fax:
Practice Address - Street 1:215 HIGH AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-4938
Practice Address - Country:US
Practice Address - Phone:731-286-1366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW BEGINNING MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========Medicaid
TN=========Medicaid