Active NPI
CG of Tennessee, LLC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Nashville, TN
National Provider Identifier
1306364054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- License
- PENDING
- Legal business name
- CG OF TENNESSEE, LLC
- Practice address
- 301 S Perimeter Park Dr
Nashville, TN 37211-4143 - Phone
- (615) 832-5454
- Fax
- (615) 837-5772
- NPI assigned
- Sep 1, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark Lashley
- Title
- Ceo
- Phone
- (817) 447-2700
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | PENDING | TN | Primary |
Addresses
Primary practice location
301 S Perimeter Park Dr
Nashville, TN 37211-4143
Mailing address
4150 International PLZ
Fort Worth, TX 76109-4892
Phone (800) 299-5161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | TN |
Other names 1
- Omni Support SOlutions
National Provider Directory
National Provider DirectoryLocations
4150 International Plz
Fort Worth, TX 76109
Phone (682) 225-6990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1765497600000",
"number": "1306364054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 INTERNATIONAL PLZ",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761094892",
"telephone_number": "800-299-5161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S PERIMETER PARK DR",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372114143",
"telephone_number": "615-832-5454",
"fax_number": "615-837-5772"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CG OF TENNESSEE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-09-01",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A",
"authorized_official_last_name": "LASHLEY",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "817-447-2700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "TN",
"license": "PENDING",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Omni Support SOlutions",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.