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General NPI Number Information
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NPI Number | 1922518760
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Entity Type | Organization
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Legal Business Name | FOUNDATION BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1916 PATTERSON ST STE 715
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City | NASHVILLE
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State | TN
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Zip | 37203-2118
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Country | US
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Telephone | 615-320-3100
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Fax | 615-320-3102
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Provider Business Mailing Address
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Address Line | 1916 PATTERSON ST STE 715
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City | NASHVILLE
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State | TN
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Zip | 37203-2118
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Country | US
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Telephone | 615-320-3100
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Fax | 615-320-3102
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Authorized Official
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Title or Position | PRACTICE ADMINSITRATOR
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Name | MELANIE G SUDBURY
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Credential | CPMA
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Telephone | 615-320-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD023785
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License Number State | TN
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