Jackson-Madison County Gen Hospital
Clinic/Center, Mental Health (Including Community Mental Health Center) in Jackson, TN. Organization (NPI-2).
NPI number1932979002
StatusActive
Last updated in NPPESJan 8, 2024
Details
- NPI
- 1932979002
- Entity type
- Organization (NPI-2)
- Legal business name
- Jackson-Madison County Gen Hospital
- Organization subpart
- No
- Enumeration date
- Jan 8, 2024
- Certification date
- Jan 8, 2024
- Last updated
- Jan 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 385HR2055X | Respite Care, Respite Care, Mental Illness, Child | – | – |
Practice location
238 Summar DrJackson, TN 38301-3906
Phone 731-541-8349
Mailing address
15 Centennial DrJackson, TN 38301-6899
Phone 731-506-9012
Authorized official
Lonell Gunn
Clinician Non-Licensed
7315069012
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