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General NPI Number Information
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NPI Number | 1043986300
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Entity Type | Organization
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Legal Business Name | LEND A HAND SUPPORTED LIVING
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 20 MCALISTER LN
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-6023
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Country | US
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Telephone | 615-513-5178
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 295
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City | FAIRVIEW
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State | TN
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Zip | 37062-0295
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Country | US
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Telephone | 161-551-3517
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DEBRA RAE HALVORSEN
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Credential |
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Telephone | 615-513-5178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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