| Senior Lifestyles. Llc | |
|
1125 Deer Creek Dr Cookeville TN 38501-6680 | |
| (931) 273-7900 | |
| Not Available |
| Full Name | Senior Lifestyles. Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1125 Deer Creek Dr, Cookeville, Tennessee |
| Authorized Official Name and Position | Brandi D Lawson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9312737900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Lifestyles. Llc 723 W Jackson St Cookeville TN 38501-3993 Ph: (931) 273-7900 | Senior Lifestyles. Llc 1125 Deer Creek Dr Cookeville TN 38501-6680 Ph: (931) 273-7900 |
| NPI Number | 1801383013 |
|---|---|
| Provider Enumeration Date | 04/13/2018 |
| Last Update Date | 04/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801383013 | NPI | - | NPPES |
| Q033896 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1000000021008 (Tennessee) | Primary |
| 283Q00000X | Psychiatric Hospital | 1000000021008 (Tennessee) | Secondary |
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