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FAIRHAVEN TREATMENT CENTER NPI 1700279080


NPI Information

NPI: 1700279080
Provider Name: FAIRHAVEN TREATMENT CENTER
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
890 N HOUSTON LEVEE RD
CORDOVA, TN
ZIP 38018
Phone: (901) 757-7979
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FAIRHAVEN TREATMENT CENTER is a community behavioral health in Cordova, TN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. FAIRHAVEN TREATMENT CENTER NPI is 1700279080. The provider is registered as an organization entity type.

The provider's business location address is:

890 N HOUSTON LEVEE RD
CORDOVA, TN
ZIP 38018-614
Phone: (901) 757-7979

The provider's authorized official is Jessica Ann Gray .
The authorized official title is Business Manager and has the following contact phone number (901) 757-7979.

The enumeration date for this NPI number is 3/11/2015 and was last updated on 3/11/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental Health14387TENNESSEENo
2261QM0855XClinic/CenterAdolescent and Children Mental Health14387TENNESSEENo
3251S00000XCommunity/Behavioral Health14387TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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