Detox West Tennessee Llc

LBN: Detox West Tennessee Llc
Detox West Tennessee Llc is an health care organization with primary practice located at 370 N Cumberland St , Jackson TN 38301-5470. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Detox West Tennessee Llc can be contacted via phone (615) 969-8612, or through Pruitt, Wilson via phone (615) 969-8612.

Contact Information

Primary practice address
370 N Cumberland St Jackson TN 38301-5470
Phone: (615) 969-8612
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pruitt, Wilson
Phone: (615) 969-8612

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1720694193
LBN Legal business name Detox West Tennessee Llc
DBA Doing business as
Authorized official Pruitt, Wilson
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2020
Last updated Sep 21st, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720694193 NPPES
Tennessee Other 971960 DOB

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