Healthcare Provider Details

I. General information

NPI: 1508257080
Provider Name (Legal Business Name): COMPLETE HOME CARE SERVICES OF TENNESSEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 CAYER LN STE D
COLUMBIA TN
38401-7384
US

IV. Provider business mailing address

2504 CAYER LN STE D
COLUMBIA TN
38401-7384
US

V. Phone/Fax

Practice location:
  • Phone: 931-451-7777
  • Fax:
Mailing address:
  • Phone: 931-451-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number50263
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CONSUELA ODEN
Title or Position: CEO
Credential:
Phone: 615-969-0551