Healthcare Provider Details

I. General information

NPI: 1669455481
Provider Name (Legal Business Name): HOME HEALTH CARE OF EAST TENNESSEE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2765 EXECUTIVE PARK NW
CLEVELAND TN
37312-2765
US

IV. Provider business mailing address

770 STUART RD NE
CLEVELAND TN
37312-5080
US

V. Phone/Fax

Practice location:
  • Phone: 423-479-6892
  • Fax: 423-718-0778
Mailing address:
  • Phone: 423-479-2757
  • Fax: 423-479-5422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number387
License Number StateTN

VIII. Authorized Official

Name: CHRISTOPHER JONES
Title or Position: CEO
Credential:
Phone: 615-733-3600