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Organization
KEITHCARE INC
Active
Organization
KEITHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY MULLIN (PERSONNEL MANAGER)
(423) 508-8006
Entity
Organization
Contact information
Practice address
8305 DAYTON PIKE STE C, SODDY DAISY, TN 37379-4202
(423) 508-8006
(423) 508-8007
Mailing address
8305 DAYTON PIKE STE C, SODDY DAISY, TN 37379-4202
(423) 508-8006
(423) 508-8007
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
L000000006479
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10109E
PROVIDER AGREEMENT WITH DIVISION OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
TN
Enumeration date
02/04/2011
Last updated
02/04/2011
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