Organization
SENIOR LIFESTYLES. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI D LAWSON MBA (EXECUTIVE DIRECTOR)
(931) 273-7900
Entity
Organization
Contact information
Practice address
1125 DEER CREEK DR, COOKEVILLE, TN 38501-6680
(931) 273-7900
Mailing address
723 W JACKSON ST, COOKEVILLE, TN 38501-3993
(931) 273-7900
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1000000021008
TN
283Q00000X
Psychiatric Hospital
1000000021008
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q033896
—
TN
Enumeration date
04/13/2018
Last updated
04/13/2018
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