Organization
SOUTHLAND BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL CAUDILL (CHIEF EXECUTIVE OFFICER)
(615) 521-9097
Entity
Organization
Contact information
Practice address
9220 PARK WEST BLVD STE 1, KNOXVILLE, TN 37923-4405
(865) 247-6754
Mailing address
9220 PARK WEST BLVD STE 1, KNOXVILLE, TN 37923-4405
(865) 247-6754
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20770
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20770
TENNESSEE STATE LICENSE NUMBER
TN
Enumeration date
05/18/2016
Last updated
03/07/2023
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