MEDICARE: HOMELIFE 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	171WH0202X	Home Modifications Contractor
2	171W00000X	Contractor	00061638	TN

General Provider Information

NPI Number	:	1497082101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMELIFE LLC

Provider Business Mailing Address
First Line	:	PO BOX 682713
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-2713
Country	:	US
Telephone Number	:	615-604-6873
Fax Number	:	615-791-0707

Provider Business Practice Location Address
First Line	:	228 PEBBLE GLEN DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-2911
Country	:	US
Telephone Number	:	615-604-6873
Fax Number	:	615-791-0707

Authorized Official
Title or Position	:	CHIEF MANAGER
Name	:	KIRK DICKSON RUTTER
Credential	:
Telephone Number	:	615-604-6873

Provider Enumeration Date	:	11/17/2009
Last Update Date	:	11/17/2009

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Directions to “HOMELIFE LLC ” Practice Location

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