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Organization
FAIRHAVEN HOLDINGS, LLC
Active
Organization
FAIRHAVEN HOLDINGS, LLC
Active
Other names
Fairhaven Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
TERI H MCCANN PHD (CLINICAL DIRECTOR)
(901) 832-9192
Entity
Organization
Contact information
Practice address
890 N HOUSTON LEVEE RD, CORDOVA, TN 38018-6614
(901) 757-7979
(901) 757-7980
Mailing address
890 N HOUSTON LEVEE RD, CORDOVA, TN 38018-6614
(901) 757-7979
(901) 757-7980
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
14386
TN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
14386
TN
Other
Enumeration date
12/06/2013
Last updated
02/07/2023
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