Organization
EXTENDED HOME CARE TN, LLC
Active
Other names
Advantage Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA M. CLARK (MANAGING DIRECTOR/ VP OF THE BOARD)
(901) 881-0645
Entity
Organization
Contact information
Practice address
7424 HWY 64 STE 118, BARTLETT, TN 38133-8937
(901) 881-0645
(901) 881-0647
Mailing address
7424 HWY 64 STE 118, BARTLETT, TN 38133-8937
(901) 881-0645
(901) 881-0647
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445629
—
TN
Enumeration date
01/13/2012
Last updated
02/18/2025
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