# SCHOLAR CARE COLLABORATIVE GROUP, INC

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

## Provider details

- **NPI number:** 1780935312
- **Authorized official:** GLORIA J. TISDELL LPN (VICE-PRESIDENT)
- **Authorized official phone:** (901) 598-7292

## Contact information

- **Practice address:** 5170 HICKORY HOLLOW PKWY UNIT 407, ANTIOCH, TN 37013-3089
- **Practice address phone:** (615) 573-2412
- **Mailing address:** 5170 HICKORY HOLLOW PKWY UNIT 407, ANTIOCH, TN 37013-3089
- **Mailing address phone:** (615) 573-2412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3140N1450X | Pediatric Skilled Nursing Facility | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | TN | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 09/22/2012
- **Last updated:** 09/22/2012