NPI 1124250733

Natchez Trace Group Home, INC.

Organisation Psychiatric Residential Treatment Facility Hohenwald, TN

Practice location

Address: 116 Kittrell St, Hohenwald, TN 38462-1363
Phone: (931) 796-4400
Fax: (931) 796-4492
Mailing address: PO Box 309, Hohenwald, TN 38462-0309

Authorised official

Name: Vincent de Koning
Title: Ceo
Phone: (931) 796-2039

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence L000000003374 (TN)

Other Psychiatric Residential Treatment Facility providers in Tennessee →

Registry record

NPI: 1124250733
Entity type: Organization
NPI issued: 14 Aug 2009
Record last updated: 14 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.