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Organization

EARHART 1

Active
Parent organization
CLOVER BOTTOM DEVELOPMENTAL CENTER
Other names
Middle Tennessee Homes
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) 231-5383
Entity
Organization

Contact information

Practice address
3156 EARHART RD, NASHVILLE, TN 37076
(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
L00000001184
TN

Other

Enumeration date
11/15/2013
Last updated
11/15/2013
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