Provider Demographics
NPI:1528418704
Name:T.A.R.P., INC
Entity Type:Organization
Organization Name:T.A.R.P., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WARDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-644-0026
Mailing Address - Street 1:1027 MINERAL WELLS AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4905
Mailing Address - Country:US
Mailing Address - Phone:731-644-0026
Mailing Address - Fax:731-644-1116
Practice Address - Street 1:1027 MINERAL WELLS AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4905
Practice Address - Country:US
Practice Address - Phone:731-644-0026
Practice Address - Fax:731-644-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ021855Medicaid