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General NPI Number Information
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NPI Number | 1376772046
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Entity Type | Organization
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Legal Business Name | HOME SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 2723 E MAGNOLIA AVE SUITE B
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City | KNOXVILLE
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State | TN
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Zip | 37914-5247
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Country | US
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Telephone | 865-525-9626
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Fax | 888-678-4908
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Provider Business Mailing Address
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Address Line | 2723 E MAGNOLIA AVE SUITE B
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City | KNOXVILLE
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State | TN
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Zip | 37914-5247
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Country | US
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Telephone | 865-525-9626
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Fax | 888-678-4908
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Authorized Official
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Title or Position | COO
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Name | MS. DIONE RODGERS
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Credential | BS
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Telephone | 865-525-9626
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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 | I000000004758
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License Number State | TN
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