Provider Demographics
NPI:1922518760
Name:FOUNDATION BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:FOUNDATION BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINSITRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SUDBURY
Authorized Official - Suffix:
Authorized Official - Credentials:CPMA
Authorized Official - Phone:615-320-3100
Mailing Address - Street 1:1916 PATTERSON ST STE 715
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2118
Mailing Address - Country:US
Mailing Address - Phone:615-320-3100
Mailing Address - Fax:615-320-3102
Practice Address - Street 1:1916 PATTERSON ST STE 715
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2118
Practice Address - Country:US
Practice Address - Phone:615-320-3100
Practice Address - Fax:615-320-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0237852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty