# EAGLES NEST MENTAL HEALTH SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295007839
- **Authorized official:** MRS. THELMA WILLENE JOHNSON LPC-MHSP (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (615) 915-4074

## Contact information

- **Practice address:** 319 PLUS PARK BLVD, SUITE 201, NASHVILLE, TN 37217-1098
- **Practice address phone:** (615) 915-4074
- **Practice address fax:** (615) 942-6392
- **Mailing address:** PO BOX 60895, NASHVILLE, TN 37206-0895
- **Mailing address phone:** (615) 915-4074
- **Mailing address fax:** (615) 942-6392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | 7929 | TN | — |
| 253Z00000X | In Home Supportive Care Agency | 7929 | TN | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 7929 | TN | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 7929 | TN | — |
| 343900000X | Non-emergency Medical Transport (VAN) | 7929 | TN | — |
| 385H00000X | Respite Care | 7929 | TN | — |

## Other

- **Enumeration date:** 01/28/2012
- **Last updated:** 02/01/2012