Provider Demographics
NPI:1831844166
Name:THE GOOD SHEPHERD SERVICES,LLC
Entity type:Organization
Organization Name:THE GOOD SHEPHERD SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA , MED
Authorized Official - Phone:615-961-3794
Mailing Address - Street 1:3604 FAIRMEADE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-1603
Mailing Address - Country:US
Mailing Address - Phone:615-961-3794
Mailing Address - Fax:
Practice Address - Street 1:604 GALLATIN AVE STE 110
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3490
Practice Address - Country:US
Practice Address - Phone:615-961-3794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services