Healthcare Provider Details

I. General information

NPI: 1326108739
Provider Name (Legal Business Name): THE KING'S DAUGHTERS' SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 W 9TH ST
COLUMBIA TN
38401-3105
US

IV. Provider business mailing address

412 W 9TH ST
COLUMBIA TN
38401-3105
US

V. Phone/Fax

Practice location:
  • Phone: 931-388-3810
  • Fax: 931-388-0405
Mailing address:
  • Phone: 931-388-3810
  • Fax: 931-388-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateTN

VIII. Authorized Official

Name: DR. DAVID CRAIG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 931-388-3810