AMANDA DAWN SELF NPI 1245815109

NPI Information

NPI: 1245815109
Provider Name: AMANDA DAWN SELF
Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Individual
Address:
1330 N MAIN ST
TENNESSEE RIDGE, TN
ZIP 37178
Phone: (888) 291-4357
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Amanda Dawn Self is an intermediate care facility mental illness in Tennessee Ridge, TN. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. Amanda Dawn Self NPI is 1245815109. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1330 N MAIN ST
TENNESSEE RIDGE, TN
ZIP 37178-003
Phone: (888) 291-4357

The enumeration date for this NPI number is 3/12/2021 and was last updated on 3/12/2021.

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	310500000X	Intermediate Care Facility, Mental Illness				Yes

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: 4/28/2024

NPI Synchronization or Removal

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