Doctor Name: | MR. TERRY BAILEY NIX JR |
NPI Number: | 1689954117 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 118 Union St Clarksville, TN - 370405115 |
Business Phone Number: | 9316478257 |
Business Fax Number: | 9316472978 |
Mailing Address: | 118 Union St, CLARKSVILLE |
State: | TN |
Postal Code: | 370405115 |
Phone Number: | 9316478257 |
Fax Number: | 9316472978 |
NPI Enumeration Date: | 08/29/2011 |
NPI Last Update Date: | 08/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |