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General NPI Number Information
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NPI Number | 1851639629
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Entity Type | Organization
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Legal Business Name | MLM SENIOR SERVICES, LLC
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 623 E MAIN ST SUITE 2
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2690
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Country | US
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Telephone | 615-338-6148
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Fax | 615-537-2385
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Provider Business Mailing Address
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Address Line | 623 E MAIN ST SUITE 2
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2690
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Country | US
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Telephone | 615-338-6148
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Fax | 615-537-2385
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL HOUSTON SLUDER
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Credential |
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Telephone | 615-338-6146
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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 | 1000000012258
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License Number State | TN
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