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Organization

SCHOLAR CARE COLLABORATIVE GROUP, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLORIA J. TISDELL LPN (VICE-PRESIDENT)
(901) 598-7292
Entity
Organization

Contact information

Practice address
5170 HICKORY HOLLOW PKWY UNIT 407, ANTIOCH, TN 37013-3089
(615) 573-2412
Mailing address
5170 HICKORY HOLLOW PKWY UNIT 407, ANTIOCH, TN 37013-3089
(615) 573-2412

Taxonomy

Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
TN
320800000X
Mental Illness Community Based Residential Treatment Facility

Other

Enumeration date
09/22/2012
Last updated
09/22/2012
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