Provider Demographics
NPI:1750192233
Name:FIRST PRESBYTERIAN CHURCH
Entity type:Organization
Organization Name:FIRST PRESBYTERIAN CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/VOLUNTEER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WADDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-624-2597
Mailing Address - Street 1:213 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-3237
Mailing Address - Country:US
Mailing Address - Phone:931-645-6551
Mailing Address - Fax:
Practice Address - Street 1:213 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3237
Practice Address - Country:US
Practice Address - Phone:931-645-6551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No385H00000XRespite Care FacilityRespite Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities