Thrive West Tennessee | |
33 Murray Guard Dr Jackson TN 38305-3610 | |
(731) 225-4295 | |
Not Available |
Full Name | Thrive West Tennessee |
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Speciality | Social Worker |
Location | 33 Murray Guard Dr, Jackson, Tennessee |
Authorized Official Name and Position | Aylmarie Taylor Laird (OWNER) |
Authorized Official Contact | 7312254295 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Thrive West Tennessee 108 Nottingham Dr Jackson TN 38305-7592 Ph: (731) 225-4295 | Thrive West Tennessee 33 Murray Guard Dr Jackson TN 38305-3610 Ph: (731) 225-4295 |
NPI Number | 1790472397 |
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Provider Enumeration Date | 04/24/2023 |
Last Update Date | 05/08/2023 |
Certification Date | 05/08/2023 |
Medicare PECOS PAC ID | 8426414426 |
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Medicare Enrollment ID | O20230517002371 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790472397 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Alymarie Taylor Laird |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114655198 PECOS PAC ID: 3476919622 Enrollment ID: I20230515001673 |
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