Provider Demographics
NPI:1710640776
Name:KNOXVILLE CENTER FOR BEHAVIORAL MEDICINE LLC
Entity Type:Organization
Organization Name:KNOXVILLE CENTER FOR BEHAVIORAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:NASON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:423-827-6092
Mailing Address - Street 1:PO BOX 1398
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-1398
Mailing Address - Country:US
Mailing Address - Phone:615-890-2020
Mailing Address - Fax:
Practice Address - Street 1:1240 TENNOVA MEDICAL WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3120
Practice Address - Country:US
Practice Address - Phone:615-890-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NHC-OP LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-18
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No333600000XSuppliersPharmacy