Organization Name: | BUFFALO VALLEY, INC. |
NPI Number: | 1710074083 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY T RISNER (EXECUTIVE DIRECTOR) |
Mailing Address: | 501 Park Ave S Hohenwald |
State: | TN US |
Postal Code: | 384621835 |
Phone Number: | 9317964256 |
Fax Number: | |
NPI Enumeration Date: | 10/06/2006 |
NPI Last Update Date: | 12/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 0000000072 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |