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CEDAR CREEK HOME HEALTH CARE AGENCY LLC NPI 1902897432


NPI Information

NPI: 1902897432
Provider Name: CEDAR CREEK HOME HEALTH CARE AGENCY, LLC

Doing Business As: DEACONESS HOMECARE

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 44D0703585

Address:
6978 LEBANON RD
SUITE B
MOUNT JULIET, TN
ZIP 37122
Phone: (615) 453-8550
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CEDAR CREEK HOME HEALTH CARE AGENCY, LLC is a home health in Mount Juliet, TN. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. CEDAR CREEK HOME HEALTH CARE AGENCY, LLC NPI is 1902897432. The provider is registered as an organization entity type.
The provider Is Doing Business As Deaconess Homecare.

The provider's business location address is:

6978 LEBANON RD
SUITE B
MOUNT JULIET, TN
ZIP 37122-201
Phone: (615) 453-8550
Fax: (615) 453-8584

The provider's authorized official is Donald D Stelly .
The authorized official title is President and has the following contact phone number (337) 233-1307.

The CLIA number assigned to this NPI record is 44D0703585 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 4/4/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251E00000XHome Health0282TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1447138MEDICARE ID-TYPE UNSPECIFIEDPROVIDER NUMBER
20447138MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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