Provider Demographics
NPI:1720220585
Name:GENERATIONS- GAITHERS, INC.
Entity Type:Organization
Organization Name:GENERATIONS- GAITHERS, INC.
Other - Org Name:GENERATIONS MENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-815-3871
Mailing Address - Street 1:300 N MCCOMBS ST
Mailing Address - Street 2:SUITE10
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-2164
Mailing Address - Country:US
Mailing Address - Phone:731-588-4152
Mailing Address - Fax:
Practice Address - Street 1:300 N MCCOMBS ST
Practice Address - Street 2:SUITE10
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-2164
Practice Address - Country:US
Practice Address - Phone:731-588-4152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000004127251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health