Scholar Care Collaborative Group, Inc

Primary specialty

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

Legal business name

SCHOLAR CARE COLLABORATIVE GROUP, INC

Practice address

5170 Hickory Hollow Pkwy Unit 407
Antioch, TN 37013-3089

Phone

(615) 573-2412

NPI assigned

Sep 22, 2012

Organization subpart

No

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

Authorized official

Name

Gloria J. Tisdell, LPN

Title

Vice-President

Phone

(901) 598-7292

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1348272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348272000000",
    "number": "1780935312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 HICKORY HOLLOW PKWY UNIT 407",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133089",
            "telephone_number": "615-573-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 HICKORY HOLLOW PKWY UNIT 407",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133089",
            "telephone_number": "615-573-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOLAR CARE COLLABORATIVE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-22",
        "last_updated": "2012-09-22",
        "status": "A",
        "authorized_official_last_name": "TISDELL",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "901-598-7292",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Antioch, TN
• Providers in Antioch, 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 Sep 22, 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.