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General NPI Number Information
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NPI Number | 1598075715
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Entity Type | Organization
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Legal Business Name | ELIZABETH CARE SERVICES, LLC
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 1326 ROSE L. PARKS BLVD. SUITE B
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City | NASHVILLE
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State | TN
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Zip | 37208
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Country | US
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Telephone | 615-942-9167
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Fax | 615-242-1315
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Provider Business Mailing Address
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Address Line | P.O. BOX 22800
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City | NASHVILLE
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State | TN
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Zip | 37202
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Country | US
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Telephone | 615-942-9167
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Fax | 615-242-1315
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CAROLINE ISIOMA IWORAH
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Credential | REGISTERED NURSE
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Telephone | 615-942-9167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 1000000005784
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License Number State | TN
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