Organization
CLOVER BOTTOM DEVELOPMENTAL CENTER
Active
Parent organization
CLOVER BOTTOM DEVELOPMENTAL CENTER
Other names
Day One
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLOVER BOTTOM DEVELOPMENTAL CENTER
Authorized official
DR. STACEY LYNN DIXON PH.D. (CHIEF OFFICER)
(615) 231-5300
Entity
Organization
Contact information
Practice address
275 STEWARTS FERRY PIKE, NASHVILLE, TN 37214-3325
(615) 231-5000
(615) 231-5074
Mailing address
275 STEWARTS FERRY PIKE, NASHVILLE, TN 37214-3325
(615) 231-5000
(615) 231-5074
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
L000000011844
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7447010
—
TN
Enumeration date
04/22/2013
Last updated
04/22/2013
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