Organization
TENNESSEE COMMUNITY SERVICES AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS D MCWHERTER (EXECUTIVE DIRECTOR)
(731) 884-2630
Entity
Organization
Contact information
Practice address
6 STONEBRIDGE BLVD, STE G, JACKSON, TN 38305-2166
(731) 984-9030
(731) 664-4623
Mailing address
PO BOX 368, 1604 WEST REELFOOT AVENUE, UNION CITY, TN 38281-0368
(731) 884-2640
(731) 884-2644
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
10000000004532
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445-085
—
TN
Enumeration date
12/01/2009
Last updated
12/01/2009
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