Organization
NEW LIFE SUPPORTIVE LIVING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARSHAL HUDDLESTON (OWNER/ OPERATOR)
(865) 850-2332
Entity
Organization
Contact information
Practice address
201 CLARK ST, LIVINGSTON, TN 38570-1608
(931) 233-7298
Mailing address
201 CLARK ST, LIVINGSTON, TN 38570-1608
(931) 233-7298
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
L219-058-4352
TN
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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