Organization
A FRESH START TO A NEW BEGINNING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NADJA MICHELLE MARION (PROGRAM COORDINATOR)
(901) 690-0327
Entity
Organization
Contact information
Practice address
213 RHONDA CIR E, CORDOVA, TN 38018-4325
(901) 690-0327
Mailing address
213 RHONDA CIR E, CORDOVA, TN 38018-4325
(901) 690-0327
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
333300000X
Emergency Response System Companies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
05/18/2019
Last updated
05/18/2019
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