Organization
SOUTH CENTRAL HUMAN RESOURCE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL T ROSSON (EXECUTIVE DIRECTOR)
(931) 433-7182
Entity
Organization
Contact information
Practice address
1437 WINCHESTER HWY, FAYETTEVILLE, TN 37334-2757
(931) 433-7182
(931) 438-0074
Mailing address
PO BOX 638, FAYETTEVILLE, TN 37334-0638
(931) 433-7182
(931) 438-0074
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445781
—
TN
Enumeration date
08/02/2019
Last updated
05/26/2021
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