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Organization
SENIOR LIFESTYLES LLC
Active
Organization
SENIOR LIFESTYLES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN RICHEY FNP-BC (NURSE PRACTITIONER)
(615) 268-9040
Entity
Organization
Contact information
Practice address
1125 DEER CREEK DR, COOKEVILLE, TN 38501-6680
(305) 240-0599
Mailing address
723 W JACKSON ST, COOKEVILLE, TN 38501-3993
(931) 520-1972
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
I000000021008
TN
363LF0000X
Family Nurse Practitioner
14453
TN
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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