Organization
LONG LIVE LIFE, INC.
Active
Other names
The Mental Health Initiative, Inc., Jonathan Adair
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ADAIR M.S. (CEO)
(615) 915-8734
Entity
Organization
Contact information
Practice address
5170 HICKORY HOLLOW PKWY UNIT 173, ANTIOCH, TN 37013-3084
(615) 988-0365
Mailing address
5170 HICKORY HOLLOW PKWY UNIT 173, ANTIOCH, TN 37013-3084
(615) 988-0365
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251300000X
Local Education Agency (LEA)
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
305R00000X
Preferred Provider Organization
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
08/08/2021
Last updated
09/22/2021
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