Provider Demographics
NPI:1801301452
Name:4M HEALTHSYSTEM INC
Entity type:Organization
Organization Name:4M HEALTHSYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:931-979-5158
Mailing Address - Street 1:269 W HUNT RD
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-1724
Mailing Address - Country:US
Mailing Address - Phone:931-979-5158
Mailing Address - Fax:
Practice Address - Street 1:827 VIRTUE RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-5344
Practice Address - Country:US
Practice Address - Phone:865-201-2705
Practice Address - Fax:865-201-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDC0000000580324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility