Healthcare Provider Details

I. General information

NPI: 1497392179
Provider Name (Legal Business Name): CARE AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 LIFE WAY
KNOXVILLE TN
37912-4151
US

IV. Provider business mailing address

401 LIFE WAY
KNOXVILLE TN
37912-4151
US

V. Phone/Fax

Practice location:
  • Phone: 865-696-0005
  • Fax:
Mailing address:
  • Phone: 865-696-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: LISA MCCASLAND
Title or Position: RN, BSN
Credential: RN, BSN
Phone: 865-696-0005