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General NPI Number Information
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NPI Number | 1841061942
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Entity Type | Organization
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Legal Business Name | TAHC - TENNESSEE LLC
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 9047 EXECUTIVE PARK DR STE 226
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City | KNOXVILLE
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State | TN
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Zip | 37923-4659
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Country | US
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Telephone | 865-839-8801
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Fax |
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Provider Business Mailing Address
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Address Line | 5299 DTC BLVD # 101
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3321
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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 | DIRECTOR OF OPERATIONS
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Name | MR. MARK ERICK HENDRICK JR.
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Credential |
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Telephone | 720-601-1712
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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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