| Wayne Provision | |
|
950 Andrew Jackson Drive Waynesboro TN 38485 | |
| (931) 722-6366 | |
| Not Available |
| Full Name | Wayne Provision |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 950 Andrew Jackson Drive, Waynesboro, Tennessee |
| Authorized Official Name and Position | Jason Scott Crews (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9317226366 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Provision Po Box 873 Waynesboro TN 38485-0873 Ph: (931) 722-6366 | Wayne Provision 950 Andrew Jackson Drive Waynesboro TN 38485 Ph: (931) 722-6366 |
| NPI Number | 1760903066 |
|---|---|
| Provider Enumeration Date | 06/28/2017 |
| Last Update Date | 09/16/2020 |
| Certification Date | 09/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760903066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Lifecare Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Jv Mangubat Dr, Medical Office-suite C, Waynesboro, TN 38485 Phone: 615-781-0013 | |
Wayne Halfway House Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 942 Andrew Jackson Dr, Waynesboro, TN 38485 Phone: 931-722-3272 Fax: 931-722-7428 |