His House

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

TNPL536621 Issued in TN

Legal business name

HIS HOUSE

Practice address

5010 Mount Zion Rd
Springfield, TN 37172-7130

Phone

(931) 881-6417

NPI assigned

May 10, 2017

Organization subpart

No

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

Authorized official

Name

Connie Mitchell

Title

Administrator

Phone

(931) 881-6417

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1821524075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 MT ZION RD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "37172",
            "telephone_number": "931-881-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 MOUNT ZION RD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371727130",
            "telephone_number": "931-881-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIS HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-10",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-881-6417"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "TN",
            "license": "TNPL536621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Leah Herrera
• Emily Anne Herrick, OTR/L
• Desiree Herring
• Ryan Heuer, OTD, OTR/L
• Kerri House Hill
• Dat Hoang
• Catherine Marshall Holden
• Christine Holland, PT
• Whitney N Holloway, OTR/L
• Cholena Pearle Hopper, DPT

• Adult Care Home Facility in Springfield, TN
• Providers in Springfield, TN by specialty
• Adult Care Home Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.