Provider Demographics
NPI:1043706427
Name:CLEARVIEW IN - HOME HEALTHCARE AGENCY
Entity type:Organization
Organization Name:CLEARVIEW IN - HOME HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:TAMEKA
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-779-9873
Mailing Address - Street 1:6099 MOUNT MORIAH ROAD EXT STE 9B
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-0311
Mailing Address - Country:US
Mailing Address - Phone:901-779-9873
Mailing Address - Fax:
Practice Address - Street 1:6099 MOUNT MORIAH ROAD EXT STE 9B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-0311
Practice Address - Country:US
Practice Address - Phone:901-779-9873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN094022215Medicaid