=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356034649
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REFLECTION CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2023
-----------------------------------------------------
Last Update Date | 09/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1161 MURFREESBORO PIKE STE 219
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37217-2222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-942-5364
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 813 ALEC CT
-----------------------------------------------------
City | NOLENSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37135-9735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-719-4208
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTORE
-----------------------------------------------------
Name | BRANDI GREEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 931-265-8789
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------