MEDICARE: IPART FAMILIES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134969348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IPART FAMILIES, LLC

Provider Business Mailing Address
First Line	:	2370 QUINLAND LAKE RD STE 112
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38506-7518
Country	:	US
Telephone Number	:	931-644-5155
Fax Number	:	931-739-5155

Provider Business Practice Location Address
First Line	:	2370 QUINLAND LAKE RD STE 112
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38506-7518
Country	:	US
Telephone Number	:	931-644-5155
Fax Number	:	931-739-5155

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	MRS. LORA ANN JARED
Credential	:
Telephone Number	:	931-644-5155

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	06/18/2024

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