Healthcare Provider Details
I. General information
NPI: 1558984096
Provider Name (Legal Business Name): GOOD SHEPHERD SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2020
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
GOOD SHEPHERD SENIOR SERVICES 1134 MURFREESBORO PIKE
NASHVILLE TN
37216
US
IV. Provider business mailing address
2908 BRANTLEY DR
ANTIOCH TN
37013-5205
US
V. Phone/Fax
- Phone: 615-416-2189
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VERNAL
SWEETING
Title or Position: OWNER
Credential:
Phone: 615-891-2462