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General NPI Number Information
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NPI Number | 1205220563
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Entity Type | Organization
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Legal Business Name | AT PROJECT KENSINGTON
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 1410 KENSINGTON SQUARE CT SUITE 104
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City | MURFREESBORO
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State | TN
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Zip | 37130-6902
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Country | US
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Telephone | 615-203-3761
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Fax | 615-203-3763
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Provider Business Mailing Address
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Address Line | 115 PENN WARREN DR SUITE 300-290
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City | BRENTWOOD
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State | TN
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Zip | 37027-5047
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Country | US
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Telephone | 615-727-8386
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Fax | 615-457-8094
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICIER
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Name | MR. PATRICK DUNN
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Credential |
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Telephone | 502-472-3728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | I000000016002
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License Number State | TN
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