Healthcare Provider Details

I. General information

NPI: 1962910414
Provider Name (Legal Business Name): ROCHELLE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 FRENCH LANDING DR
NASHVILLE TN
37228-1601
US

IV. Provider business mailing address

237 FRENCH LANDING DR
NASHVILLE TN
37228-1601
US

V. Phone/Fax

Practice location:
  • Phone: 615-635-0323
  • Fax:
Mailing address:
  • Phone: 615-635-0323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number15391
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number15391
License Number StateTN

VIII. Authorized Official

Name: KAYLA MILBURN
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 615-635-0419