Organization
DETOX WEST TENNESSEE LLC
Active
Organization
DETOX WEST TENNESSEE LLC
Active
Other names
Brentwood Springs Detox
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON PRUITT (CEO)
(615) 400-5005
Entity
Organization
Contact information
Practice address
370 N CUMBERLAND ST, JACKSON, TN 38301-5470
(615) 969-8612
Mailing address
370 N CUMBERLAND ST, JACKSON, TN 38301-5470
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
971960
DOB
TN
Enumeration date
09/21/2020
Last updated
05/20/2026
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