Healthcare Provider Details
I. General information
NPI: 1710640552
Provider Name (Legal Business Name): LSR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2021
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2201 MURFREESBORO PIKE STE C205
NASHVILLE TN
37217-3438
US
IV. Provider business mailing address
104 WALTERS AVE
FRANKLIN TN
37067-2602
US
V. Phone/Fax
- Phone: 615-586-7535
- Fax: 615-692-0348
- Phone: 615-586-7535
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LSR
CORPORATION
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 615-586-7335