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General NPI Number Information
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NPI Number | 1780313569
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Entity Type | Organization
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Legal Business Name | GENTLE CARE RESIDENTIAL, LLC
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 2201 MURFREESBORO PIKE STE D202
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City | NASHVILLE
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State | TN
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Zip | 37217-3556
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Country | US
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Telephone | 615-559-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 3041 BARNES BEND DR
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City | ANTIOCH
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State | TN
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Zip | 37013-4475
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Country | US
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Telephone | 615-559-2220
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TSEHAYE TESHOME
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Credential |
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Telephone | 615-559-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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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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