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General NPI Number Information
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NPI Number | 1831844166
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Entity Type | Organization
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Legal Business Name | THE GOOD SHEPHERD SERVICES,LLC
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 604 GALLATIN AVE STE 110
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City | NASHVILLE
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State | TN
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Zip | 37206-3490
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Country | US
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Telephone | 615-961-3794
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Fax |
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Provider Business Mailing Address
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Address Line | 3604 FAIRMEADE DR
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City | NASHVILLE
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State | TN
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Zip | 37218-1603
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Country | US
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Telephone | 615-961-3794
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MARY JO MORTON
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Credential | MA. , MED
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Telephone | 615-961-3794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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