Provider Demographics
NPI:1770321127
Name:THE JENKINS CENTER LLC
Entity type:Organization
Organization Name:THE JENKINS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:615-670-0602
Mailing Address - Street 1:300 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-1709
Mailing Address - Country:US
Mailing Address - Phone:615-670-0602
Mailing Address - Fax:615-688-9503
Practice Address - Street 1:300 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-1709
Practice Address - Country:US
Practice Address - Phone:615-688-9504
Practice Address - Fax:615-688-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty