Provider Demographics
NPI:1912258914
Name:NIA ASSOCIATION, INC.
Entity type:Organization
Organization Name:NIA ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:HEASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-444-2486
Mailing Address - Street 1:375 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-4144
Mailing Address - Country:US
Mailing Address - Phone:931-906-3993
Mailing Address - Fax:931-503-0472
Practice Address - Street 1:375 DOVER RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4144
Practice Address - Country:US
Practice Address - Phone:931-906-3993
Practice Address - Fax:931-503-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251E00000X, 251X00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251X00000XAgenciesSupports Brokerage