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General NPI Number Information
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NPI Number | 1982653077
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Entity Type | Organization
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Legal Business Name | BONNESANT ENTERPRISES, LLC
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 1914 MCARTHUR ST
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City | MANCHESTER
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State | TN
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Zip | 37355-2624
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Country | US
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Telephone | 931-728-2453
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Fax | 931-728-2411
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Provider Business Mailing Address
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Address Line | 1914 MCARTHUR ST
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City | MANCHESTER
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State | TN
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Zip | 37355-2624
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Country | US
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Telephone | 931-728-2453
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Fax | 931-728-2411
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Authorized Official
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Title or Position | CEO
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Name | MR. DAN HOGAN
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Credential |
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Telephone | 931-728-2453
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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 | 0000000029
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License Number State | TN
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