Joeys Yacht Club Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

JOEYS YACHT CLUB INC

Practice address

3937 Pepperwood Dr
Antioch, TN 37013-1677

Phone

(615) 342-9590

Fax

(615) 255-9967

NPI assigned

Nov 15, 2011

Organization subpart

No

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

Authorized official

Name

Alice Williams

Title

President

Phone

(615) 342-9590

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1851678189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3937 PEPPERWOOD DR",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370131677",
            "telephone_number": "615-342-9590",
            "fax_number": "615-255-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 PEPPERWOOD DR",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370131677",
            "telephone_number": "615-342-9590",
            "fax_number": "615-255-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEYS YACHT CLUB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-342-9590"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.