Open Home Transitional Living

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

I0000000010203 Issued in TN

Legal business name

OPEN HOME TRANSITIONAL LIVING

Practice address

6010 Cortez CT
Hermitage, TN 37076-2404

Phone

(615) 668-3917

NPI assigned

Jan 15, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Robert Burns Jackson

Title

Owner

Phone

(615) 668-3917

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1215274873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 CORTEZ CT",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762404",
            "telephone_number": "615-668-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 CORTEZ CT",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762404",
            "telephone_number": "615-668-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN HOME TRANSITIONAL LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BURNS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-668-3917",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "I0000000010203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Hermitage, TN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.