Fairhaven Treatment Center

NPI 1700279080 - Clinic/Center - 261QM0850X

NPI Details
NPI 1700279080
Enumeration Date 03/11/2015
Last Updated 03/11/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name JESSICA ANN JESSICA
Position BUSINESS MANAGER
Phone (901) 757-7979
Fax
Practice Location
890 N HOUSTON LEVEE RD
CORDOVA TN, 38018-6614, US
Phone (901) 757-7979
Fax
Business Location
890 N HOUSTON LEVEE RD
CORDOVA TN, 38018-6614, US
Phone (901) 757-7979
Fax
Toxanomy
Taxonomy Code 261QM0850X
License State Tennessee
License Number 14387
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According to our database, Fairhaven Treatment Center NPI is 1700279080, taxonomy code is 261QM0850X and license number is 14387, license state is located at Tennessee. Fairhaven Treatment Center physically located at 890 N Houston Levee Rd, Cordova TN, 38018-6614. NPI Number 1033115704 has the healthcare provider type.

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1700279080 NPI number is provided on an as is basis without warranty of any kind. 1700279080 is maintained by the National Plan & Provider Enumeration System. The contents of Fairhaven Treatment Center are for informational purposes only.