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General NPI Number Information
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NPI Number | 1881736122
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Entity Type | Organization
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Legal Business Name | PARK CENTER
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 1935 21ST AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-3997
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Country | US
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Telephone | 615-242-3576
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Fax | 615-242-3580
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Provider Business Mailing Address
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Address Line | 1935 21ST AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-3997
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Country | US
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Telephone | 615-242-3576
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Fax | 615-242-3580
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | WILL CONNELLY
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Credential |
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Telephone | 615-242-3576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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