Provider Demographics
NPI:1538367578
Name:TRUSTED SENIOR CARE, LLC
Entity type:Organization
Organization Name:TRUSTED SENIOR CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-842-7540
Mailing Address - Street 1:2475 SCOTTSVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4483
Mailing Address - Country:US
Mailing Address - Phone:270-842-7540
Mailing Address - Fax:270-842-7436
Practice Address - Street 1:2475 SCOTTSVILLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4483
Practice Address - Country:US
Practice Address - Phone:270-842-7540
Practice Address - Fax:270-842-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health