| NPI | 1093110546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL LEATHERMAN Owner/Director/Manager 615-456-4013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TN 671766) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: TN 671766) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: TN 0000002538) | |
| 347C00000X Private Vehicle (Licence: TN 087330800) | |
| 385H00000X Respite Care (Licence: TN 0000002538) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |