Provider Demographics
NPI:1144836982
Name:CENTERSTONE OF TENNESSE INC.
Entity type:Organization
Organization Name:CENTERSTONE OF TENNESSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECURITY OFFICER, IT TECHNOLOGY SUP
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-463-6523
Mailing Address - Street 1:PO BOX 197520
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-7520
Mailing Address - Country:US
Mailing Address - Phone:615-463-6669
Mailing Address - Fax:615-463-6506
Practice Address - Street 1:7011 A C SKINNER PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6954
Practice Address - Country:US
Practice Address - Phone:904-431-3500
Practice Address - Fax:904-431-3501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERSTONE OF TENNESSE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)