Healthcare Provider Details

I. General information

NPI: 1043542418
Provider Name (Legal Business Name): CONNEXUS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 KERMIT DR SUITE 102
NASHVILLE TN
37217-2126
US

IV. Provider business mailing address

5425 CROSSINGS BLVD
ANTIOCH TN
37013-3149
US

V. Phone/Fax

Practice location:
  • Phone: 615-883-5633
  • Fax: 615-704-0008
Mailing address:
  • Phone: 615-883-5633
  • Fax: 615-704-0008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberL000000005918
License Number StateTN

VIII. Authorized Official

Name: TINA R HILL
Title or Position: PRESIDENT
Credential:
Phone: 615-883-5633