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General NPI Number Information
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NPI Number | 1033587761
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Entity Type | Organization
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Legal Business Name | AT HOME- HOMECARE SERVICES
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 354 DEJARNETTE LN
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City | MURFREESBORO
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State | TN
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Zip | 37130-9093
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Country | US
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Telephone | 615-617-3586
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Fax |
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Provider Business Mailing Address
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Address Line | 354 DEJARNETTE LN
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City | MURFREESBORO
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State | TN
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Zip | 37130-9093
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Country | US
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Telephone | 615-617-3586
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Fax |
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Authorized Official
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Title or Position | NURSE ASSISTANT
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Name | MRS. PAMELA LATRICE VAUGHN
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Credential | NURSE
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Telephone | 615-617-3586
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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 | TN
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