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General NPI Number Information
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NPI Number | 1689944944
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Entity Type | Organization
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Legal Business Name | STEVEDONNA, INC
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 1110 S MAIN ST
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City | MILAN
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State | TN
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Zip | 38358-2726
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Country | US
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Telephone | 731-613-2526
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Fax | 731-613-2505
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Provider Business Mailing Address
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Address Line | 1110 S MAIN ST
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City | MILAN
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State | TN
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Zip | 38358-2726
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Country | US
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Telephone | 731-613-2526
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Fax | 731-613-2505
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Authorized Official
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Title or Position | CO-OWNER
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Name | MAX STEPHEN SMITH
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Credential |
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Telephone | 731-613-2526
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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 | 1000000010009
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License Number State | TN
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