# MENTAL HEALTH CENTERS & CLINICS OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** QUINCO MENTAL HEALTH CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255442794
- **Authorized official:** MEDLIN MARLIN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (731) 658-6113

## Contact information

- **Practice address:** 10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
- **Practice address phone:** (731) 658-6113
- **Practice address fax:** (731) 658-6165
- **Mailing address:** 10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
- **Mailing address phone:** (731) 658-6113
- **Mailing address fax:** (731) 658-6165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | L 214-076-6309 | TN | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 04/02/2019