Healthcare Provider Details

I. General information

NPI: 1346114618
Provider Name (Legal Business Name): ELITE CARE OF TENNESSEE HOMEHEALTH L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 BEAVER TRAIL DR
CORDOVA TN
38016-1520
US

IV. Provider business mailing address

1485 BEAVER TRAIL DR
CORDOVA TN
38016-1520
US

V. Phone/Fax

Practice location:
  • Phone: 901-570-6691
  • Fax:
Mailing address:
  • Phone: 901-570-6691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: TANISHA COLEMAN
Title or Position: PHYSICAL THERAPIST ASSISTANT
Credential:
Phone: 901-570-6691