Provider Demographics
NPI:1871328971
Name:HOME CARE SUPPORT PLUS LLC
Entity type:Organization
Organization Name:HOME CARE SUPPORT PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIYOGUSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-260-5655
Mailing Address - Street 1:9111 CROSS PARK DR STE 236
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4506
Mailing Address - Country:US
Mailing Address - Phone:412-260-5655
Mailing Address - Fax:412-229-8764
Practice Address - Street 1:9111 CROSS PARK DR STE 236
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4506
Practice Address - Country:US
Practice Address - Phone:412-260-5655
Practice Address - Fax:412-229-8764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health