Life Center for a New Tomorrow, LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Woodbury, TN

NPI 1881908010 · NPPES record last updated Jul 29, 2010

Key facts

NPI
1881908010
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
LIFE CENTER FOR A NEW TOMORROW, LLC
Practice address
220 Sunshine LN
Woodbury, TN 37190-4002
Phone
(615) 563-4292
Fax
(615) 563-4292
NPI assigned
Jul 29, 2010
Organization subpart
No

Authorized official

Name
Marc Vallieres
Title
Owner/Manager
Phone
(615) 563-4292

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 6994 TN

Addresses

Primary practice location

220 Sunshine LN
Woodbury, TN 37190-4002

Mailing address

461 Cedar Crest LN
Woodbury, TN 37190-6184
Phone (615) 563-4292

Other identifiers

IdentifierTypeStateIssuer
H445433MedicaidTN

Other providers in Woodbury, TN

All providers in Woodbury, TN · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Tennessee

Sources for this page

Verify at the official NPI Registry.