Healthcare Provider Details

I. General information

NPI: 1447527643
Provider Name (Legal Business Name): BUBBA'S BETTER LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 CENTERVIEW RD
SAVANNAH TN
38372-7215
US

IV. Provider business mailing address

265 CENTERVIEW RD
SAVANNAH TN
38372-7215
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-4905
  • Fax: 731-925-4906
Mailing address:
  • Phone: 731-925-4905
  • Fax: 731-925-4906

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: JOHN MICHAEL MORRISON
Title or Position: PRESIDENT
Credential:
Phone: 731-925-4905