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General NPI Number Information
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NPI Number | 1588629950
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Entity Type | Organization
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Legal Business Name | J.W. CARELL ENTERPRISES, LLC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 118 MABRY HOOD RD STE 100
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City | KNOXVILLE
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State | TN
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Zip | 37922-2219
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Country | US
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Telephone | 865-531-9988
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Fax | 865-531-9949
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Provider Business Mailing Address
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Address Line | 118 MABRY HOOD RD STE 100
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City | KNOXVILLE
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State | TN
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Zip | 37922-2219
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Country | US
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Telephone | 865-531-9988
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Fax | 865-531-9949
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHEAL CARELL
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Credential |
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Telephone | 615-781-0666
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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 | 0000000131
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License Number State | TN
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