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NPI Code Detail

MEDICARE: WE CARE HOME ASSISTANCE OF TN LLC

MEDICARE: WE CARE HOME ASSISTANCE OF TN 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
1385H00000XRespite Care

General Provider Information

NPI Number : 1932584661
Entity Type Code : Organization
Provider Name (Legal Business Name) : WE CARE HOME ASSISTANCE OF TN LLC
Provider Business Mailing Address
First Line : PO BOX 72
Second Line :
City : JEFFERSON CITY
State : TN
Zip : 37760-0072
Country : US
Telephone Number : 865-262-8481
Fax Number : 865-262-8843
Provider Business Practice Location Address
First Line : 430 CLEARBROOK DR
Second Line :
City : JEFFERSON CITY
State : TN
Zip : 37760-2088
Country : US
Telephone Number : 865-262-8481
Fax Number : 865-262-8843
Authorized Official
Title or Position : SOLE MEMBER
Name : RICHARD L RICKETTS
Credential :
Telephone Number : 865-262-8481
Provider Enumeration Date : 07/23/2015
Last Update Date : 07/23/2015

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Directions to “WE CARE HOME ASSISTANCE OF TN LLC ” Practice Location

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