| Lantern Lane Farm | |
|
6201 Corinth Rd Mount Juliet TN 37122-7603 | |
| (615) 584-6959 | |
| Not Available |
| Full Name | Lantern Lane Farm |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6201 Corinth Rd, Mount Juliet, Tennessee |
| Authorized Official Name and Position | Ralph Cook (CEO) |
| Authorized Official Contact | 6155846959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lantern Lane Farm 6201 Corinth Rd Mount Juliet TN 37122-7603 Ph: (615) 584-6959 | Lantern Lane Farm 6201 Corinth Rd Mount Juliet TN 37122-7603 Ph: (615) 584-6959 |
| NPI Number | 1952726036 |
|---|---|
| Provider Enumeration Date | 02/26/2014 |
| Last Update Date | 02/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952726036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5836 (Tennessee) | Primary |
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