JABBOK TREATMENT CENTER LLC. NPI 1740639962

NPI Information

NPI: 1740639962
Provider Name: JABBOK TREATMENT CENTER, LLC.
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
40 IRWIN ST
SAVANNAH, TN
ZIP 38372
Phone: (731) 727-5603
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JABBOK TREATMENT CENTER, LLC. is an addiction medicine family medicine in Savannah, TN. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. JABBOK TREATMENT CENTER, LLC. NPI is 1740639962. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

40 IRWIN ST
SAVANNAH, TN
ZIP 38372-084
Phone: (731) 727-5603
Fax: (731) 925-2114

The provider's authorized official is Jacqueline D Irwin .
The authorized official title is Owner/coo and has the following contact phone number 77316167753.

The enumeration date for this NPI number is 6/8/2016 and was last updated on 6/8/2016.

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
1	207QA0401X	Family Medicine	Addiction Medicine	207QA0401X	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1521170	MEDICAID	TENNESSEE
2	02000211	MEDICAID	TENNESSEE

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

NPI Synchronization or Removal

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