Provider Demographics
NPI:1982358131
Name:XODUS PROVIDER SERVICES INC
Entity Type:Organization
Organization Name:XODUS PROVIDER SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOSHEIDRU
Authorized Official - Middle Name:R
Authorized Official - Last Name:YANCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-596-4034
Mailing Address - Street 1:8 N HILL ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-3462
Mailing Address - Country:US
Mailing Address - Phone:615-596-4034
Mailing Address - Fax:
Practice Address - Street 1:8 N HILL ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-3462
Practice Address - Country:US
Practice Address - Phone:615-596-4034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNHOMECAREOtherHOME CARE