Organization
MENTAL HEALTH CENTERS & CLINICS OF TENNESSEE
Active
Other names
QUINCO MENTAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MEDLIN MARLIN (EXECUTIVE DIRECTOR)
(731) 658-6113
Entity
Organization
Contact information
Practice address
10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
(731) 658-6113
(731) 658-6165
Mailing address
10710 OLD HIGHWAY 64, BOLIVAR, TN 38008-3587
(731) 658-6113
(731) 658-6165
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L 214-076-6309
TN
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008479
BCBS
TN
05
—
3706936
—
TN
Enumeration date
08/31/2006
Last updated
04/02/2019
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