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General NPI Number Information
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NPI Number | 1144520511
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Entity Type | Organization
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Legal Business Name | MIRIAM'S PROMISE
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 522 RUSSELL ST
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City | NASHVILLE
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State | TN
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Zip | 37206-4114
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Country | US
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Telephone | 615-292-6500
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Fax | 615-292-0368
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Provider Business Mailing Address
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Address Line | 522 RUSSELL ST
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City | NASHVILLE
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State | TN
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Zip | 37206-4114
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Country | US
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Telephone | 615-292-6500
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Fax | 615-292-0368
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DEBORAH ROBINSON
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Credential | M.A.
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Telephone | 615-292-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SO/10619
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License Number State | TN
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