Organization
NEW PURPOSE
Active
Other names
NIA Association
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLON HEASTON (CEO)
(931) 906-3993
Entity
Organization
Contact information
Practice address
2509 WILMA RUDOLPH BLVD STE D, CLARKSVILLE, TN 37040-6425
(931) 906-3993
(931) 503-0472
Mailing address
2509 WILMA RUDOLPH BLVD STE D, CLARKSVILLE, TN 37040-6425
(931) 906-3993
(931) 503-0472
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
TN
251X00000X
Supports Brokerage Agency
—
TN
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/01/2012
Last updated
05/05/2026
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