Natchez Trace Group Home, Inc.

NPI #1124250733 in Hohenwald, Tennessee

Provider Information

NPI Number
1124250733
Entity Type
Organization
Organization Name
Natchez Trace Group Home, Inc.
Primary Specialty
Psychiatric Residential Treatment Facility
Enumeration Date
Aug 14, 2009
Last Updated
Aug 14, 2009

Practice Location

Address
116 KITTRELL ST
ZIP Code
38462-1363
Phone
(931) 796-4400

Authorized Official

Name
MR. VINCENT DE KONING
Title
CEO
Phone
(931) 796-2039

Specialties & Taxonomy Codes

Specialty
Psychiatric Residential Treatment Facility

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