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General NPI Number Information
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NPI Number | 1235637711
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Entity Type | Organization
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Legal Business Name | ONE LIFE TECH
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 190 REED RD
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City | CROSSVILLE
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State | TN
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Zip | 38572-1347
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Country | US
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Telephone | 931-787-3702
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Fax |
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Provider Business Mailing Address
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Address Line | 190 REED RD
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City | CROSSVILLE
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State | TN
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Zip | 38572-1347
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACY J. PUGH
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Credential |
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Telephone | 931-787-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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