MEDICARE: UNITY RESIDENTIAL SERVICES,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	L000000006174	TN

General Provider Information

NPI Number	:	1326357633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITY RESIDENTIAL SERVICES,INC.

Provider Business Mailing Address
First Line	:	PO BOX 3530
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37024-3530
Country	:	US
Telephone Number	:	615-313-8107
Fax Number	:	888-387-7130

Provider Business Practice Location Address
First Line	:	2228 ROSA L PARKS BLVD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1306
Country	:	US
Telephone Number	:	615-313-8107
Fax Number	:	888-387-7130

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CHITOKA WEBB
Credential	:
Telephone Number	:	615-313-8107

Provider Enumeration Date	:	10/04/2010
Last Update Date	:	10/04/2010

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