| Organization Name: | PERSONAL CARE SERVICES OF TN, LLC |
| NPI Number: | 1235421421 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WALTER L BLACK (EXECUTIVE DIRECTOR) |
| Mailing Address: | 201 W Liberty Ave Ste. 105 Covington |
| State: | TN US |
| Postal Code: | 380192500 |
| Phone Number: | 9013139238 |
| Fax Number: | 9013139236 |
| NPI Enumeration Date: | 05/06/2011 |
| NPI Last Update Date: | 05/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 1000000008567 |
| 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 |