Provider Demographics
NPI:1902142201
Name:FISHIELD CORPORATION
Entity Type:Organization
Organization Name:FISHIELD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:STELLA
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-355-9445
Mailing Address - Street 1:325 PLUS PARK BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-1067
Mailing Address - Country:US
Mailing Address - Phone:615-366-9445
Mailing Address - Fax:
Practice Address - Street 1:325 PLUS PARK BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-1067
Practice Address - Country:US
Practice Address - Phone:615-366-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
103G706788OtherMEDICARE
TN1528970OtherTN CARE