Provider Demographics
NPI:1871925818
Name:JENNY KAY CAREGIVERS, LLC
Entity type:Organization
Organization Name:JENNY KAY CAREGIVERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-389-8160
Mailing Address - Street 1:3132 POSSUM TROT RD
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:TN
Mailing Address - Zip Code:37073-4718
Mailing Address - Country:US
Mailing Address - Phone:615-389-8160
Mailing Address - Fax:615-863-0045
Practice Address - Street 1:3132 POSSUM TROT RD
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:TN
Practice Address - Zip Code:37073-4718
Practice Address - Country:US
Practice Address - Phone:615-389-8160
Practice Address - Fax:615-863-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000012892253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN300589098Medicaid