MEDICARE: HOME WITH HOPE, 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	171WH0202X	Home Modifications Contractor	00006589	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12345	OTHER	TN	NO PREVIOUS NPI

General Provider Information

NPI Number	:	1710271317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME WITH HOPE, INC.

Provider Business Mailing Address
First Line	:	109 HOLIDAY CT STE B3
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-3083
Country	:	US
Telephone Number	:	615-724-1634
Fax Number	:	615-661-4505

Provider Business Practice Location Address
First Line	:	109 HOLIDAY CT STE B3
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-3083
Country	:	US
Telephone Number	:	615-724-1634
Fax Number	:	615-661-4505

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RON LEE
Credential	:
Telephone Number	:	615-724-1634

Provider Enumeration Date	:	06/01/2011
Last Update Date	:	10/16/2020

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Directions to “HOME WITH HOPE, INC. ” Practice Location

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