Provider Demographics
NPI:1942607288
Name:ACCESS HOME HEALTH CARE AGENCY,LLC
Entity type:Organization
Organization Name:ACCESS HOME HEALTH CARE AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-842-2400
Mailing Address - Street 1:5340 GARDEN TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-9445
Mailing Address - Country:US
Mailing Address - Phone:901-842-2400
Mailing Address - Fax:901-207-2807
Practice Address - Street 1:5340 GARDEN TRAIL LN
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-9445
Practice Address - Country:US
Practice Address - Phone:901-842-2400
Practice Address - Fax:901-207-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445512Medicaid