Provider Demographics
NPI:1659795094
Name:CENTERSTONE
Entity Type:Organization
Organization Name:CENTERSTONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:GADZO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:615-945-5809
Mailing Address - Street 1:1408 STAUNTON MILL CT
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-2304
Mailing Address - Country:US
Mailing Address - Phone:615-945-5809
Mailing Address - Fax:
Practice Address - Street 1:1408 STAUNTON MILL CT
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-2304
Practice Address - Country:US
Practice Address - Phone:615-945-5809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management