Provider Demographics
NPI:1841624749
Name:STONES RIVER CENTER
Entity type:Organization
Organization Name:STONES RIVER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:IZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-895-7788
Mailing Address - Street 1:3350 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0208
Mailing Address - Country:US
Mailing Address - Phone:615-895-7788
Mailing Address - Fax:615-895-6999
Practice Address - Street 1:3350 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0208
Practice Address - Country:US
Practice Address - Phone:615-895-7788
Practice Address - Fax:615-895-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services