MEDICARE: WILLOWBROOK HEALTH & HOME SERVICES, INC.

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	261QM1300X	Multi-Specialty Clinic/Center	PSS0000000115	TN

General Provider Information

NPI Number	:	1174520407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOWBROOK HEALTH & HOME SERVICES, INC.

Provider Business Mailing Address
First Line	:	1451 ELM HILL PIKE
Second Line	:	SUITE 300
City	:	NASHVILLE
State	:	TN
Zip	:	37210-5512
Country	:	US
Telephone Number	:	615-366-6060
Fax Number	:	615-366-3331

Provider Business Practice Location Address
First Line	:	1451 ELM HILL PIKE
Second Line	:	SUITE 201
City	:	NASHVILLE
State	:	TN
Zip	:	37210-4560
Country	:	US
Telephone Number	:	615-361-1951
Fax Number	:	615-361-8173

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE & REIMBURSEMENT
Name	:	TINA M HARGIS
Credential	:
Telephone Number	:	615-366-3214

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	05/12/2008

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