Healthcare Provider Details

I. General information

NPI: 1609005032
Provider Name (Legal Business Name): ARMOR VALLEY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 FORT CAMPBELL BLVD STE A
CLARKSVILLE TN
37042-3280
US

IV. Provider business mailing address

2026 FORT CAMPBELL BLVD STE A
CLARKSVILLE TN
37042-3280
US

V. Phone/Fax

Practice location:
  • Phone: 931-552-2769
  • Fax: 931-553-8003
Mailing address:
  • Phone: 931-552-2769
  • Fax: 931-553-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberL000000005102
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License NumberL000000005102
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberL000000005102
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberL000000005102
License Number StateTN

VIII. Authorized Official

Name: MRS. NATASHA DAWN DRAKE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 931-552-2769