Organization
180 RED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY LYNCH PH.D. (CEO)
(615) 669-8372
Entity
Organization
Contact information
Practice address
93 BEAUMONT ST, CLARKSVILLE, TN 37040-3217
(931) 274-7588
Mailing address
93 BEAUMONT ST, CLARKSVILLE, TN 37040-3217
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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