Organization
YOUTH TOWN OF TENNESSEE, INC.
Active
Organization
YOUTH TOWN OF TENNESSEE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK SUMMAR (EXECUTIVE DIRECTOR)
(731) 988-5251
Entity
Organization
Contact information
Practice address
3641 YOUTH TOWN RD, PINSON, TN 38366-9804
(731) 988-5251
(731) 427-5605
Mailing address
PO BOX 1385, JACKSON, TN 38302-1385
(731) 988-5251
(731) 427-5605
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
I000000002836
TN
101YM0800X
Mental Health Counselor
I000000002836
TN
324500000X
Substance Abuse Rehabilitation Facility
Primary
0000000507
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5441227
—
TN
Enumeration date
10/13/2006
Last updated
06/17/2020
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