Organization
TENNESSEE DETOX CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER JENKINS (CHIEF EXECUTIVE OFFICER)
(817) 797-1407
Entity
Organization
Contact information
Practice address
509 LAKE FOREST DR, LA VERGNE, TN 37086-5204
(817) 797-1407
Mailing address
509 LAKE FOREST DR, LA VERGNE, TN 37086-5204
(817) 797-1407
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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