Retire at Home Senior Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

RETIRE AT HOME SENIOR CARE LLC

Practice address

501 Mose Dr
Sparta, TN 38583-1212

Phone

(615) 567-5852

Fax

(866) 704-5370

NPI assigned

Oct 20, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Tahir Rajab, RN

Title

President

Phone

(256) 499-0984

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1316222375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MOSE DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831212",
            "telephone_number": "615-567-5852",
            "fax_number": "866-704-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MOSE DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831212",
            "telephone_number": "615-567-5852",
            "fax_number": "866-704-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETIRE AT HOME SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "RAJAB",
        "authorized_official_first_name": "TAHIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-499-0984",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "L000000009368",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H445263",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.