Organization
CENTERSTONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINGER R BENNETT (PRN COUNSELOR)
(931) 461-0290
Entity
Organization
Contact information
Practice address
207 W BLACKWELL ST, TULLAHOMA, TN 37388-3395
(931) 461-0290
(931) 461-0209
Mailing address
207 W BLACKWELL ST, TULLAHOMA, TN 37388-3395
(931) 461-0290
(931) 461-0209
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/17/2009
Last updated
08/17/2009
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