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General NPI Number Information
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NPI Number | 1003454844
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Entity Type | Organization
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Legal Business Name | SUNCREST COMPANION SERVICES, LLC
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 101 TENNESSEE WAY STE 200A
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3160
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Country | US
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Telephone | 615-823-1281
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Fax | 615-866-2296
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-233-5764
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L. PROFFITT
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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