Organization
CENTERSTONE OF AMERICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE LARVEL RICKETTS (RESIDENTIAL COUNSELOR)
(615) 460-4290
Entity
Organization
Contact information
Practice address
717 HART LN, NASHVILLE, TN 37216-2007
(615) 460-4290
Mailing address
717 HART LN, NASHVILLE, TN 37216-2007
(615) 460-4290
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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