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General NPI Number Information
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NPI Number | 1346997194
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Entity Type | Organization
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Legal Business Name | MEADOWS OUTPATIENT CENTER TENNESSEE LLC
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 131 3RD AVE N STE 205
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City | FRANKLIN
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State | TN
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Zip | 37064-2534
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Country | US
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Telephone | 928-684-4083
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Fax |
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Provider Business Mailing Address
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Address Line | 19820 N 7TH ST STE 205
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City | PHOENIX
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State | AZ
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Zip | 85024-1694
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Country | US
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Telephone | 928-684-4083
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Fax |
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Authorized Official
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Title or Position | VP OF REVENUE CYCLE MANAGEMENT
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Name | TRACY LIVINGSTON
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Credential |
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Telephone | 928-684-4039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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