Provider Demographics
NPI:1427350123
Name:AT HOME HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:AT HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-964-4500
Mailing Address - Street 1:22 MONUMENT RD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUMMERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38483-0000
Mailing Address - Country:US
Mailing Address - Phone:931-964-4500
Mailing Address - Fax:931-964-4533
Practice Address - Street 1:22 MONUMENT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUMMERTOWN
Practice Address - State:TN
Practice Address - Zip Code:38483-7644
Practice Address - Country:US
Practice Address - Phone:931-964-4500
Practice Address - Fax:931-964-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN167439143313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility