Organization
LIFE CENTER FOR A NEW TOMORROW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC VALLIERES (OWNER/MANAGER)
(615) 563-4292
Entity
Organization
Contact information
Practice address
220 SUNSHINE LN, WOODBURY, TN 37190-4002
(615) 563-4292
(615) 563-4292
Mailing address
461 CEDAR CREST LN, WOODBURY, TN 37190-6184
(615) 563-4292
(615) 563-4292
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
6994
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445433
—
TN
Enumeration date
07/29/2010
Last updated
07/29/2010
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