Provider Demographics
NPI:1265717961
Name:CENTERSTONE
Entity type:Organization
Organization Name:CENTERSTONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-580-0503
Mailing Address - Street 1:7305 HENRY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-8911
Mailing Address - Country:US
Mailing Address - Phone:615-519-2128
Mailing Address - Fax:
Practice Address - Street 1:7305 HENRY DR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-8911
Practice Address - Country:US
Practice Address - Phone:615-519-2128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERSTONE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN105405901251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management