Living Water Prevention Program Facility

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

I000000004501 Issued in TN

Legal business name

LIVING WATER PREVENTION PROGRAM FACILITY

Practice address

959 Old Cookeville Rd
Sparta, TN 38583-5616

Phone

(931) 738-8102

NPI assigned

Jun 30, 2009

Organization subpart

Yes

Parent organization

VOLUNTEER CHRISTIAN ACADEMY INCAs reported in NPPES

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

Authorized official

Name

Linda Caskey

Title

Sec-Treas

Phone

(931) 738-8102

Specialties & licenses 1

Addresses

Tax ID family

Living Water Prevention Program Facility2 organizations share this tax ID, including this one

Part of

Living Water Prevention Program Facility

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Volunteer Recovery Center

  • Community/Behavioral Health Agency
  • Sparta, TN
  • NPI 1932644101
  NPD tax ID

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1184852048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 OLD COOKEVILLE RD",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385835616",
            "telephone_number": "931-738-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 OLD COOKEVILLE RD",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385835616",
            "telephone_number": "931-738-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATER PREVENTION PROGRAM FACILITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VOLUNTEER CHRISTIAN ACADEMY INC",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "CASKEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "SEC-TREAS",
        "authorized_official_telephone_number": "931-738-8102"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TN",
            "license": "I000000004501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Behavioral Health
• Jason Lee Lewis, MA, MBC, LMFT, MPA
• Life Force, LLC
• Life Reimagined LLC
• Tyler Livesay
• Tammy Rhea Loftis, P.T.
• Jeffrey D Loveland, DPM
• Kathleen Loyd
• Kelly Lyons, A.P.N.
• Olivia Martin, MA

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sparta, TN
• Providers in Sparta, TN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.