Organization
CORDERRO CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMAYA NICOLE JOHNSON BPS-HS CLPN (DIRECTOR/OWNER)
(901) 239-3812
Entity
Organization
Contact information
Practice address
575 S ROYAL ST STE 38, JACKSON, TN 38301-7307
(901) 239-3812
Mailing address
575 S ROYAL ST STE 38, JACKSON, TN 38301-7307
(901) 239-3812
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/30/2024
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