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General NPI Number Information
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NPI Number | 1831913334
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Entity Type | Organization
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Legal Business Name | MANA SPRINGS PSYCHIATRIC CARE, LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 133 FRANKLIN ST
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City | CLARKSVILLE
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State | TN
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Zip | 37040-3437
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Country | US
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Telephone | 615-852-6256
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Fax | 931-903-1200
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Provider Business Mailing Address
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Address Line | 133 FRANKLIN ST
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City | CLARKSVILLE
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State | TN
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Zip | 37040-3437
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Country | US
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Telephone |
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Fax | 931-903-1200
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Authorized Official
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Title or Position | PMHNP-BC
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Name | WILLIE LEMUSU
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Credential | APRN
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Telephone | 615-852-6256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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