Provider Demographics
NPI:1073848172
Name:WAVES, INC.
Entity Type:Organization
Organization Name:WAVES, INC.
Other - Org Name:WAVES EARLY CHILDHOOD LEARNING PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-794-9602
Mailing Address - Street 1:435 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2755
Mailing Address - Country:US
Mailing Address - Phone:615-794-9602
Mailing Address - Fax:615-791-9179
Practice Address - Street 1:435 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2755
Practice Address - Country:US
Practice Address - Phone:615-794-9602
Practice Address - Fax:615-791-9179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAVES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000005184252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency