Organization
WKDA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTY COBB BS (OWNER/PROGRAM ADMINSTRATOR)
(270) 247-4212
Entity
Organization
Contact information
Practice address
1720 E REELFOOT AVE, SUITE 101, UNION CITY, TN 38261-6047
(731) 884-9010
(270) 247-2017
Mailing address
1720 E REELFOOT AVE, SUITE 101, UNION CITY, TN 38261-6047
(731) 884-9010
(270) 247-2017
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
I000000013974
TN
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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