Latoya Blake

Individual provider Active NPI Home Health Agency · Portland, TN

NPI 1336658707 · NPPES record last updated Sep 28, 2017

Key facts

NPI
1336658707
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
Practice address
104 Elise LN
Portland, TN 37148-2200
Phone
(615) 440-0127
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

104 Elise LN
Portland, TN 37148-2200

Mailing address

104 Elise LN
Portland, TN 37148-2200
Phone (615) 440-0127

Other providers in Portland, TN

All providers in Portland, TN · Home Health Agency in Tennessee

Sources for this page

Verify at the official NPI Registry.