Healthcare Provider Details

I. General information

NPI: 1134969348
Provider Name (Legal Business Name): IPART FAMILIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 QUINLAND LAKE RD STE 112
COOKEVILLE TN
38506-7518
US

IV. Provider business mailing address

2370 QUINLAND LAKE RD STE 112
COOKEVILLE TN
38506-7518
US

V. Phone/Fax

Practice location:
  • Phone: 931-644-5155
  • Fax: 931-739-5155
Mailing address:
  • Phone: 931-644-5155
  • Fax: 931-739-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LORA ANN JARED
Title or Position: OWNER/MEMBER
Credential:
Phone: 931-644-5155