Provider Demographics
NPI:1477727824
Name:CENTERSTONE
Entity Type:Organization
Organization Name:CENTERSTONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-223-5840
Mailing Address - Street 1:418 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3135
Mailing Address - Country:US
Mailing Address - Phone:931-388-0078
Mailing Address - Fax:931-388-0866
Practice Address - Street 1:418 W 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3135
Practice Address - Country:US
Practice Address - Phone:931-388-0078
Practice Address - Fax:931-388-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility