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General NPI Number Information
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NPI Number | 1336854041
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Entity Type | Organization
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Legal Business Name | VSTAR BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 126 E MAIN ST STE B
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City | UNION CITY
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State | TN
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Zip | 38261-3350
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Country | US
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Telephone | 731-599-9929
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Fax |
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Provider Business Mailing Address
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Address Line | 126 E MAIN ST STE B
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City | UNION CITY
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State | TN
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Zip | 38261-3350
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Country | US
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Telephone | 731-599-9929
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | VIRGIL WILLIAMS
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Credential |
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Telephone | 731-599-9929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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