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General NPI Number Information
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NPI Number | 1619328432
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Entity Type | Organization
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Legal Business Name | STAND BY ME
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Dates
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Enumeration Date | 06/22/2016
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Last Update Date | 06/22/2016
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Provider Practice Location Address
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Address Line | 304 NASHBORO GREENS WAY
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City | NASHVILLE
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State | TN
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Zip | 37217-3931
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Country | US
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Telephone | 615-423-1361
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Fax |
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Provider Business Mailing Address
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Address Line | 304 NASHBORO GREENS WAY
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City | NASHVILLE
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State | TN
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Zip | 37217-3931
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Country | US
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Telephone | 615-423-1361
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AHMED JAMA
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Credential |
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Telephone | 615-423-1361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 192897
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License Number State | TN
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