Provider Demographics
NPI:1578092284
Name:BLUESPRING BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:BLUESPRING BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DIONNE
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, BCBA
Authorized Official - Phone:615-881-1203
Mailing Address - Street 1:1313 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-7412
Mailing Address - Country:US
Mailing Address - Phone:615-881-1203
Mailing Address - Fax:866-936-1472
Practice Address - Street 1:1313 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-7412
Practice Address - Country:US
Practice Address - Phone:615-881-1203
Practice Address - Fax:866-936-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health