| Organization Name: | KIDD SENIOR CARE SERVICE, INC. |
| NPI Number: | 1043597271 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOUGLAS E KIDD (PRESIDENT/OWNER) |
| Mailing Address: | 750 Old Hickory Blvd Bldg. 2, Suite 150 Brentwood |
| State: | TN US |
| Postal Code: | 370274528 |
| Phone Number: | 6153716101 |
| Fax Number: | 6153731582 |
| NPI Enumeration Date: | 11/16/2011 |
| NPI Last Update Date: | 11/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | I000000008486 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |