Organization
JACKSON CENTER FOR INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY BETH JAMES (EXECUTIVE DIRECTOR)
(731) 668-2211
Entity
Organization
Contact information
Practice address
1981 HOLLYWOOD DR, SUITE 200, JACKSON, TN 38305-4368
(731) 668-2211
(731) 668-0406
Mailing address
1981 HOLLYWOOD DR, SUITE 200, JACKSON, TN 38305-4368
(731) 668-2211
(731) 668-0406
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q021666
—
TN
Enumeration date
06/16/2016
Last updated
06/16/2016
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