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General NPI Number Information
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NPI Number | 1497163760
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Entity Type | Organization
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Legal Business Name | COMER HOUSE OF NASHVILLE LLC
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 1603 14TH AVE N
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City | NASHVILLE
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State | TN
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Zip | 37208-2034
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Country | US
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Telephone | 615-320-1862
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Fax |
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Provider Business Mailing Address
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Address Line | 1603 14TH AVE N
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City | NASHVILLE
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State | TN
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Zip | 37208-2034
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Country | US
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Telephone | 615-320-1862
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Fax |
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Authorized Official
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Title or Position | OWNER / EXECUTIVE DIRECTOR
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Name | MR. JOE COMER JR.
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Credential |
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Telephone | 615-506-5766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | L000000016361
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License Number State | TN
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