Provider Demographics
| NPI: | 1265976096 |
|---|---|
| Name: | GROUP EFFORT INC. |
| Entity type: | Organization |
| Organization Name: | GROUP EFFORT INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR OF BUSINESS |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DEREK |
| Authorized Official - Middle Name: | SHAROD |
| Authorized Official - Last Name: | POTTER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 615-499-4659 |
| Mailing Address - Street 1: | 3441 LEBANON PIKE |
| Mailing Address - Street 2: | SUITE 112 & 113 |
| Mailing Address - City: | HERMITAGE |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37076-2097 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 615-499-4659 |
| Mailing Address - Fax: | 615-216-2168 |
| Practice Address - Street 1: | 3441 LEBANON PIKE |
| Practice Address - Street 2: | SUITE 112 & 113 |
| Practice Address - City: | HERMITAGE |
| Practice Address - State: | TN |
| Practice Address - Zip Code: | 37076-2097 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 615-499-4659 |
| Practice Address - Fax: | 615-216-2168 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2016-12-13 |
| Last Update Date: | 2016-12-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TN | I000000019286 | 251S00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health |