Efc #2 | |
603 Amana Ave. Fayetteville TN 37334 | |
(931) 240-0682 | |
(931) 240-0054 |
Full Name | Efc #2 |
---|---|
Speciality | Community/behavioral Health |
Location | 603 Amana Ave., Fayetteville, Tennessee |
Authorized Official Name and Position | Rose L Dodge (OWNER) |
Authorized Official Contact | 9319523499 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Efc #2 603 Amana Ave. Fayetteville TN 37334 Ph: (931) 240-0682 | Efc #2 603 Amana Ave. Fayetteville TN 37334 Ph: (931) 240-0682 |
NPI Number | 1528897451 |
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Provider Enumeration Date | 07/30/2024 |
Last Update Date | 07/31/2024 |
Certification Date | 07/31/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528897451 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
320700000X | Residential Treatment Facility, Physical Disabilities | (* (Not Available)) | Secondary |
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