Provider Demographics
NPI:1043986300
Name:LEND A HAND SUPPORTED LIVING
Entity type:Organization
Organization Name:LEND A HAND SUPPORTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:HALVORSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-513-5178
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-0295
Mailing Address - Country:US
Mailing Address - Phone:161-551-3517
Mailing Address - Fax:
Practice Address - Street 1:20 MCALISTER LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-6023
Practice Address - Country:US
Practice Address - Phone:615-513-5178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care