Organization
JOEYS YACHT CLUB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE WILLIAMS (PRESIDENT)
(615) 342-9590
Entity
Organization
Contact information
Practice address
3937 PEPPERWOOD DR, ANTIOCH, TN 37013-1677
(615) 342-9590
(615) 255-9967
Mailing address
3937 PEPPERWOOD DR, ANTIOCH, TN 37013-1677
(615) 342-9590
(615) 255-9967
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/15/2011
Last updated
11/16/2011
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