Organization
STAFFCO OF EASTERN TENNESSEE, LLC.
Active
Other names
At Home Healthcare of East Tennessee
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON NIPPS B.S. (MANAGING MEMBER)
(423) 473-9922
Entity
Organization
Contact information
Practice address
2654 PEERLESS RD NW, CLEVELAND, TN 37312-3732
(423) 473-9922
(423) 473-9924
Mailing address
2654 PEERLESS RD NW, CLEVELAND, TN 37312-3732
(423) 473-9922
(423) 473-9924
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
L000000005138
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000005138
STATE OF TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
TN
05
—
H445298
—
TN
Enumeration date
12/01/2009
Last updated
12/01/2009
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