1770515538 NPI number — MINISTRY HOME CARE, LLC.

Table of content: (NPI 1770515538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770515538 NPI number — MINISTRY HOME CARE, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MINISTRY HOME CARE, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770515538
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 CADILLAC DR STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-1001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
153-777-0226
Provider Business Mailing Address Fax Number:
615-373-4457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 W UPHAM ST STE 208
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHFIELD
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54449-1483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
153-017-3007
Provider Business Practice Location Address Fax Number:
877-991-5059
Provider Enumeration Date:
07/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADKINS
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP CHIEF LEGAL OFFICER
Authorized Official Telephone Number:
615-309-5668

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 901040 . This is a "CERTIFICATION" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".