Individual
YUL C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
747 TIMBER CREEK DR STE 9, CORDOVA, TN 38018-6397
(901) 484-6568
(901) 567-4919
Mailing address
747 TIMBER CREEK DR STE 9, CORDOVA, TN 38018-6397
(901) 484-6568
(901) 567-4919
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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