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General NPI Number Information
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NPI Number | 1346724143
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Entity Type | Organization
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Legal Business Name | TK HOME KARING SERVICE
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 209 CROLL CT APT 125
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City | CHATTANOOGA
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State | TN
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Zip | 37410-1017
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Country | US
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Telephone | 423-432-9401
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80232
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City | CHATTANOOGA
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State | TN
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Zip | 37414-7232
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Country | US
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Telephone | 440-895-7316
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Fax |
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Authorized Official
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Title or Position | PROVIDER/CNA
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Name | MRS. KIESHA HAZELRAY
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Credential |
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Telephone | 423-432-9401
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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 |
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