Organization
WAYNE PROVISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SCOTT CREWS (EXECUTIVE DIRECTOR)
(931) 722-6366
Entity
Organization
Contact information
Practice address
950 ANDREW JACKSON DRIVE, WAYNESBORO, TN 38485
(931) 722-6366
Mailing address
PO BOX 873, WAYNESBORO, TN 38485-0873
(931) 722-6366
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/28/2017
Last updated
09/16/2020
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