Healthcare Provider Details

I. General information

NPI: 1902142201
Provider Name (Legal Business Name): FISHIELD CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 12/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 PLUS PARK BLVD STE 101
NASHVILLE TN
37217-1067
US

IV. Provider business mailing address

325 PLUS PARK BLVD STE 101
NASHVILLE TN
37217-1067
US

V. Phone/Fax

Practice location:
  • Phone: 615-366-9445
  • Fax:
Mailing address:
  • Phone: 615-366-9445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateTN

VIII. Authorized Official

Name: MARGARET STELLA FISHER
Title or Position: MENTAL HEALTH ADMINISTRATOR
Credential:
Phone: 615-355-9445