Organization
PARK CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILL CONNELLY (PRESIDENT CEO)
(615) 242-3576
Entity
Organization
Contact information
Practice address
1935 21ST AVE S, NASHVILLE, TN 37212-3997
(615) 242-3576
(615) 242-3580
Mailing address
1935 21ST AVE S, NASHVILLE, TN 37212-3997
(615) 242-3576
(615) 242-3580
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3729366
—
TN
Enumeration date
02/13/2007
Last updated
10/07/2022
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