Provider Demographics
NPI:1528684925
Name:HOWARD SUPPORTIVE CARE AGENCY, LLC
Entity type:Organization
Organization Name:HOWARD SUPPORTIVE CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-228-5088
Mailing Address - Street 1:3009 TOWERWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37406-2142
Mailing Address - Country:US
Mailing Address - Phone:423-228-5088
Mailing Address - Fax:423-803-6461
Practice Address - Street 1:6741 RINGGOLD RD STE F
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-4246
Practice Address - Country:US
Practice Address - Phone:423-228-5088
Practice Address - Fax:423-803-6461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty