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General NPI Number Information
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NPI Number | 1730833716
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL LIVING HOME AND HEALTHCARE SERVICES
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 149 BONITA PKWY # 108
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3907
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Country | US
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Telephone | 615-722-7011
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Fax |
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Provider Business Mailing Address
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Address Line | 149 BONITA PKWY # 108
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MELINDA DABIO
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Credential | OTD OTR/L
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Telephone | 615-722-7011
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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 |
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License Number State |
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