Provider Demographics
NPI:1194268375
Name:A PLACE CALLED HOME
Entity type:Organization
Organization Name:A PLACE CALLED HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LOWRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:MMS
Authorized Official - Phone:731-393-0136
Mailing Address - Street 1:25 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:MC KENZIE
Mailing Address - State:TN
Mailing Address - Zip Code:38201-2033
Mailing Address - Country:US
Mailing Address - Phone:731-393-0136
Mailing Address - Fax:731-393-0158
Practice Address - Street 1:25 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:MC KENZIE
Practice Address - State:TN
Practice Address - Zip Code:38201-2033
Practice Address - Country:US
Practice Address - Phone:731-393-0136
Practice Address - Fax:731-393-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000014435253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445210Medicaid