1669455481 NPI number — HOME HEALTH CARE OF EAST TENNESSEE, INC.

Table of content: (NPI 1669455481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669455481 NPI number — HOME HEALTH CARE OF EAST TENNESSEE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH CARE OF EAST TENNESSEE, INC.
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:
6
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:
1669455481
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
770 STUART RD NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37312-5080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-479-2757
Provider Business Mailing Address Fax Number:
423-479-5422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2765 EXECUTIVE PARK NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37312-2765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-479-6892
Provider Business Practice Location Address Fax Number:
423-718-0778
Provider Enumeration Date:
11/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
615-733-3600

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  387 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com