Organization
FUNCTIONAL INDEPENDENCE HOME CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE BOLES (CEO)
(901) 363-6046
Entity
Organization
Contact information
Practice address
270 GERMAN OAK DR, CORDOVA, TN 38018-7220
(901) 363-6046
(901) 546-7663
Mailing address
270 GERMAN OAK DR, CORDOVA, TN 38018-7220
(901) 363-6046
(901) 546-7662
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0000000610
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000610
STATE LICENSURE NUMBER
TN
05
—
0447567
—
TN
Enumeration date
05/26/2006
Last updated
02/14/2025
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