| Previously Transformation Inc. | |
|
1088 Rogers Road Cordova TN 38018 | |
| (901) 755-1396 | |
| Not Available |
| Full Name | Previously Transformation Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1088 Rogers Road, Cordova, Tennessee |
| Authorized Official Name and Position | J Neil Smith (OWNER CEO) |
| Authorized Official Contact | 9017750099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Previously Transformation Inc. 1088 Rogers Road Cordova TN 38018 Ph: (901) 755-1396 | Previously Transformation Inc. 1088 Rogers Road Cordova TN 38018 Ph: (901) 755-1396 |
| NPI Number | 1982757316 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 06/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982757316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | I2(15)M2-096-9685 (Tennessee) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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