Organization
IMIND GERIATRICS AND BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID COOK (MANAGER)
(731) 267-3154
Entity
Organization
Contact information
Practice address
312 GREENHILL DR, JACKSON, TN 38305-5716
(731) 300-0810
Mailing address
65 MURRAY GUARD DR, JACKSON, TN 38305-3628
(731) 300-0810
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
01/03/2025
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