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Organization

LIFELINE HOME HEALTH CARE OF UNION CITY, LLC

Active
Other names
Extendicare Home Health of Western Tennessee
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD D. STELLY (PRESIDENT)
(337) 233-1307
Entity
Organization

Contact information

Practice address
1720 EAST REELFOOT AVENUE, SUITE 203, UNION CITY, TN 38261-6049
(731) 885-0866
(731) 885-0327
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
00000188
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0447434
TN
Enumeration date
09/21/2006
Last updated
08/08/2013
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