Provider Demographics
NPI:1619224870
Name:TENNESSEE COMMUNITY & COURT SERVICES
Entity type:Organization
Organization Name:TENNESSEE COMMUNITY & COURT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREATMENT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:COSBY
Authorized Official - Suffix:
Authorized Official - Credentials:LADAC
Authorized Official - Phone:901-872-3020
Mailing Address - Street 1:4800 NAVY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-1914
Mailing Address - Country:US
Mailing Address - Phone:901-872-3020
Mailing Address - Fax:901-872-3019
Practice Address - Street 1:4800 NAVY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1914
Practice Address - Country:US
Practice Address - Phone:901-872-3020
Practice Address - Fax:901-872-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN872101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty