Organization
CLARA BUTLER NURSING AND PERSONAL CARE SERVICE INC. FOR AGING AND DISA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA BUTLER (EXECUTIVE DIRECTOR/OWNER)
(901) 314-3112
Entity
Organization
Contact information
Practice address
4210 ALTRURIA RD STE 102, BARTLETT, TN 38135-9241
(901) 314-3112
(901) 266-2435
Mailing address
4210 ALTRURIA RD STE 102, BARTLETT, TN 38135-9241
(901) 314-3112
(901) 266-2435
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
S7894
TN
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
S7894
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q017814
—
TN
Enumeration date
01/06/2012
Last updated
12/07/2016
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