Healthcare Provider Details

I. General information

NPI: 1972075869
Provider Name (Legal Business Name): INCLUDE ME ADVOCACY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2018
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 2ND AVE S
NASHVILLE TN
37201-2366
US

IV. Provider business mailing address

222 2ND AVE S
NASHVILLE TN
37201-2366
US

V. Phone/Fax

Practice location:
  • Phone: 615-200-0414
  • Fax:
Mailing address:
  • Phone: 615-200-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER FARMER
Title or Position: CO-FOUNDER
Credential:
Phone: 615-200-0414