Organization
JACKSON-MADISON COUNTY GEN HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONELL GUNN BA, MS, NCC (CLINICIAN NON-LICENSED)
(731) 506-9012
Entity
Organization
Contact information
Practice address
238 SUMMAR DR, JACKSON, TN 38301-3906
(731) 541-8349
Mailing address
15 CENTENNIAL DR, JACKSON, TN 38301-6899
(731) 506-9012
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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