Natchez Trace Group Home, Inc.
Organization Active NPI Psychiatric Residential Treatment Facility · Hohenwald, TN
NPI 1124250733 · NPPES record last updated Aug 14, 2009
Key facts
- NPI
- 1124250733
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Residential Treatment Facility 323P00000X
- License
- L000000003374 (TN)
- Legal business name
- NATCHEZ TRACE GROUP HOME, INC.
- Practice address
- 116 Kittrell St
Hohenwald, TN 38462-1363 - Phone
- (931) 796-4400
- Fax
- (931) 796-4492
- NPI assigned
- Aug 14, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Vincent De Koning
- Title
- Ceo
- Phone
- (931) 796-2039
National Provider Directory
Locations
116 Kittrell St
Hohenwald, TN 38462
Phone (931) 796-4400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Residential Treatment Facility | 323P00000X | L000000003374 | TN | Yes |
Addresses
Primary practice location
116 Kittrell St
Hohenwald, TN 38462-1363
Mailing address
PO Box 309
Hohenwald, TN 38462-0309
Phone (931) 796-2039
Other providers in Hohenwald, TN
- William Gerald McCann
- Samuel McConnell
- Medical Necessities & Services LLC
- Mary Elizabeth Middleton
- Jane Q Morton
- National Seating & Mobility, Inc
- Jennifer Dawn Neal
- Neuroscience Institute on Addiction
- Paul J Niner III
- Heather Lynn Norris
All providers in Hohenwald, TN · Psychiatric Residential Treatment Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.