Provider Demographics
NPI:1932584661
Name:WE CARE HOME ASSISTANCE OF TN LLC
Entity Type:Organization
Organization Name:WE CARE HOME ASSISTANCE OF TN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICKETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-262-8481
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-0072
Mailing Address - Country:US
Mailing Address - Phone:865-262-8481
Mailing Address - Fax:865-262-8843
Practice Address - Street 1:430 CLEARBROOK DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2088
Practice Address - Country:US
Practice Address - Phone:865-262-8481
Practice Address - Fax:865-262-8843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care