Organization
SOBER LIVING OF TENNESSEE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES STUBBLEFIELD (COMPLIANCE OFFICER)
(931) 979-5158
Entity
Organization
Contact information
Practice address
402 S COLLEGE ST, SMITHVILLE, TN 37166-1900
(931) 979-5158
Mailing address
269 W HUNT RD, ALCOA, TN 37701-1724
(931) 979-5158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I00000000004367
LICENSE
TN
Enumeration date
07/12/2017
Last updated
06/16/2018
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