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General NPI Number Information
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NPI Number | 1760879811
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Entity Type | Organization
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Legal Business Name | THREE GENERATIONS HOME HEALTH CARE
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 3704 CLARKSVILLE PIKE SUITE B
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City | NASHVILLE
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State | TN
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Zip | 37218-2202
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Country | US
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Telephone | 615-427-8743
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 ROGER AVE
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City | NASHVILLE
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State | TN
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Zip | 37207-4933
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Country | US
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Telephone | 615-427-8743
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Fax |
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Authorized Official
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Title or Position | HEALTHCARE PROVIDER
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Name | SHAKELA KEONTE BASS
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Credential |
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Telephone | 615-427-8743
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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 |
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License Number State |
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