Provider Demographics
NPI:1487839437
Name:TENNESSEE VALLEY HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:TENNESSEE VALLEY HEALTH CARE SYSTEM
Other - Org Name:VETERAN'S ADMINISTRATION
Other - Org Type:Other Name
Authorized Official - Title/Position:ADDICTION THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:CAC
Authorized Official - Phone:615-893-1360
Mailing Address - Street 1:3400 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1236
Mailing Address - Country:US
Mailing Address - Phone:615-893-1360
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1237
Practice Address - Country:US
Practice Address - Phone:615-893-1360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL796A261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health