Provider Demographics
NPI:1154720902
Name:ANDERSON IN-HOME CARE
Entity type:Organization
Organization Name:ANDERSON IN-HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-300-0058
Mailing Address - Street 1:187 LOUIS RHEA DR
Mailing Address - Street 2:
Mailing Address - City:SNEEDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37869-3022
Mailing Address - Country:US
Mailing Address - Phone:423-300-0058
Mailing Address - Fax:423-733-4952
Practice Address - Street 1:187 LOUIS RHEA DR
Practice Address - Street 2:
Practice Address - City:SNEEDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37869-3022
Practice Address - Country:US
Practice Address - Phone:423-300-0058
Practice Address - Fax:423-733-4952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care