Organization
CLOVER BOTTOM DEV. CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEVI HARRIS (CHIEF OFFICER)
(615) 231-5372
Entity
Organization
Contact information
Practice address
275 STEWARTS FERRY PIKE, NASHVILLE, TN 37214-3325
(615) 231-5372
(615) 231-5121
Mailing address
275 STEWARTS FERRY PIKE, NASHVILLE, TN 37214-3325
(615) 231-5372
(615) 231-5121
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
L 323-096-3521
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4414378
PHARMACY NCPDP NUMBER
TN
05
—
7447010
—
TN
Enumeration date
02/08/2007
Last updated
08/22/2020
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