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General NPI Number Information
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NPI Number | 1306458690
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Entity Type | Organization
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Legal Business Name | ADDICTION CAMPUSES PROFESSIONAL SERVICES OF MASSACHUSETTS PLLC
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 151 SOUTH ST
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City | CUMMINGTON
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State | MA
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Zip | 01026-9501
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Country | US
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Telephone | 413-634-3600
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Fax | 413-634-5300
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Provider Business Mailing Address
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Address Line | 205 REIDHURST AVE
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City | NASHVILLE
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State | TN
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Zip | 37203-1618
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Country | US
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Telephone | 615-921-4447
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Fax | 615-921-5918
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Authorized Official
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Title or Position | SENIOR DIRECTOR
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Name | LEIGH ANN THOMPSON
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Credential |
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Telephone | 615-921-4447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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