Provider Demographics
NPI:1770975724
Name:CERTIFIED CARE
Entity type:Organization
Organization Name:CERTIFIED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:Q
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-554-4624
Mailing Address - Street 1:PO BOX 111681
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37222-1681
Mailing Address - Country:US
Mailing Address - Phone:615-554-4624
Mailing Address - Fax:615-523-2484
Practice Address - Street 1:2404 GREENS CIR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2864
Practice Address - Country:US
Practice Address - Phone:615-554-4624
Practice Address - Fax:615-523-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-28
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000017111251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health