Healthcare Provider Details

I. General information

NPI: 1114717345
Provider Name (Legal Business Name): DEEP SPRINGS HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 AIRPORT RD
SPARTA TN
38583-5200
US

IV. Provider business mailing address

210 AIRPORT RD
SPARTA TN
38583-5200
US

V. Phone/Fax

Practice location:
  • Phone: 931-284-5588
  • Fax:
Mailing address:
  • Phone: 931-284-5588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL AKEHINMI
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 931-284-5588