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Organization
LONG LIVE LIFE, INC.
Active
Organization
LONG LIVE LIFE, INC.
Active
Other names
The Mental Health Initiative, Inc., Jonathan Adair
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ADAIR M.S. (CEO)
(615) 915-8734
Entity
Organization
Contact information
Practice address
5170 HICKORY HOLLOW PKWY UNIT 173, ANTIOCH, TN 37013-3084
(615) 988-0365
Mailing address
5170 HICKORY HOLLOW PKWY UNIT 173, ANTIOCH, TN 37013-3084
(615) 988-0365
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
—
NULL
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
NULL
171W00000X
Contractor
—
—
251300000X
Local Education Agency (LEA)
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
305R00000X
Preferred Provider Organization
—
NULL
305S00000X
Point of Service
—
NULL
Other
Enumeration date
08/08/2021
Last updated
09/22/2021
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