Healthcare Provider Details

I. General information

NPI: 1972104693
Provider Name (Legal Business Name): SPRINGHEALTH BEHAVIORAL HEALTH AND INTEGRATED CARE TENNESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 HANSON CT STE 101
MURFREESBORO TN
37129-2765
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-5186
US

V. Phone/Fax

Practice location:
  • Phone: 859-200-1650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGIE MATTINGLY
Title or Position: MANAGER-PROVIDER ENROLLMENT
Credential:
Phone: 502-394-2100