Healthcare Provider Details
I. General information
NPI: 1811503246
Provider Name (Legal Business Name): LINK HOME SERVICES OF TN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2020
Last Update Date: 03/13/2024
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
208 W DUE WEST AVE
MADISON TN
37115-4568
US
IV. Provider business mailing address
180 SYLVAN AVE STE 2
ENGLEWOOD CLIFFS NJ
07632-2519
US
V. Phone/Fax
- Phone: 917-855-2114
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| 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:
MARK
FRIEDMAN
Title or Position: MEMBER
Credential:
Phone: 178-552-1149