CGC Supportive Living

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

L000000010545 Issued in TN

Legal business name

CGC SUPPORTIVE LIVING

Practice address

711 Johnson St
Murfreesboro, TN 37130-5129

Phone

(615) 895-9751

NPI assigned

Jul 30, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gregory Earl Smith

Title

Co-Owner

Phone

(615) 554-2508

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1003162975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 MIDDLE TENNESSEE BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371305108",
            "telephone_number": "615-890-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 JOHNSON ST",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371305129",
            "telephone_number": "615-895-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGC SUPPORTIVE LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "615-554-2508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "TN",
            "license": "L000000010545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Mental Illness Community Based Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.