Janice Ballard
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Brownsville, TN. Individual provider (NPI-1).
NPI number1699449652
StatusActive
Last updated in NPPESAug 3, 2021
Details
- NPI
- 1699449652
- Entity type
- Individual (NPI-1)
- Name
- Ms. Janice Ballard
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2021
- Certification date
- Aug 3, 2021
- Last updated
- Aug 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | L000000020690 | TN | Yes |
Practice location
55 Kleer Vu DrBrownsville, TN 38012-2165
Phone 901-338-2678 · Fax 731-326-5081
Mailing address
55 Kleer Vu DrBrownsville, TN 38012-2165
Phone 901-338-2678 · Fax 731-326-5081
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