Provider Demographics
NPI:1952298812
Name:STEADFAST HEALTH PROFESSIONAL SERVICES TENNESSEE PC
Entity type:Organization
Organization Name:STEADFAST HEALTH PROFESSIONAL SERVICES TENNESSEE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-422-1581
Mailing Address - Street 1:1900 PATTERSON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2165
Mailing Address - Country:US
Mailing Address - Phone:866-935-0936
Mailing Address - Fax:330-319-7828
Practice Address - Street 1:1900 PATTERSON ST STE 205
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2165
Practice Address - Country:US
Practice Address - Phone:866-935-0936
Practice Address - Fax:330-319-7828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health