Organization Active NPI

Tiarashaven & Support Services LLC

  • In Home Supportive Care Agency
  • Cordova, TN
National Provider Identifier
1205770203
Registry record updated Apr 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
TIARASHAVEN & SUPPORT SERVICES LLC
Practice address
7533 Daisy Grove Dr Apt 1
Cordova, TN 38016-3617
Phone
(901) 647-0438
NPI assigned
Apr 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bryan Keith Sullins, PHD
Title
Member / Organizer
Phone
(901) 647-0438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

7533 Daisy Grove Dr Apt 1
Cordova, TN 38016-3617

Mailing address

7533 Daisy Grove Dr Apt 1
Cordova, TN 38016-3617
Phone (901) 647-0438

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776470400000",
    "number": "1205770203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7533 DAISY GROVE DR APT 1",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380163617",
            "telephone_number": "901-647-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7533 DAISY GROVE DR APT 1",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380163617",
            "telephone_number": "901-647-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIARASHAVEN & SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-18",
        "last_updated": "2026-04-18",
        "certification_date": "2026-04-18",
        "status": "A",
        "authorized_official_last_name": "SULLINS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MEMBER / ORGANIZER",
        "authorized_official_telephone_number": "901-647-0438",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.