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General NPI Number Information
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NPI Number | 1992870125
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Entity Type | Organization
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Legal Business Name | VANDERBILT COMMUNITY MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1601 23RD AVE S FL 3
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City | NASHVILLE
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State | TN
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Zip | 37212-3133
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Country | US
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Telephone | 615-532-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 PEWTER CT
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City | MADISON
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State | TN
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Zip | 37115-5906
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Country | US
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Telephone | 615-865-6084
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH CLINICIAN 2
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Name | MS. MARY ROMBOKAS
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Credential | M.ED.
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Telephone | 615-532-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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