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General NPI Number Information
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NPI Number | 1437636222
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Entity Type | Organization
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Legal Business Name | HOME OF POTENTIAL AND EXCELLENCE
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 2996A WINDEMERE CIRCLE
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City | NASHVILLE
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State | TN
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Zip | 37214
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Country | US
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Telephone | 615-802-0322
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Fax |
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Provider Business Mailing Address
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Address Line | 4636 LEBANON PIKE # 247
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City | HERMITAGE
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State | TN
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Zip | 37076-1316
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Country | US
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Telephone | 615-802-0322
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHEMICKA ADAMS
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Credential | LBA, BCBA
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Telephone | 615-802-0322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-1624755
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License Number State | TN
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