| A Minds' Way Home | |
|
364 N Parkway Ste 6 Jackson TN 38305-2874 | |
| (731) 693-2047 | |
| Not Available |
| Full Name | A Minds' Way Home |
|---|---|
| Speciality | Clinic/Center |
| Location | 364 N Parkway Ste 6, Jackson, Tennessee |
| Authorized Official Name and Position | Talea L Brown (EXECUTIVE DIRECTOR/PROVIDER) |
| Authorized Official Contact | 7316932047 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Minds' Way Home 364 N Parkway Ste 6 Jackson TN 38305-2874 Ph: (731) 693-2047 | A Minds' Way Home 364 N Parkway Ste 6 Jackson TN 38305-2874 Ph: (731) 693-2047 |
| NPI Number | 1699350918 |
|---|---|
| Provider Enumeration Date | 03/17/2021 |
| Last Update Date | 03/17/2021 |
| Certification Date | 03/17/2021 |
| Medicare PECOS PAC ID | 8123425907 |
|---|---|
| Medicare Enrollment ID | O20210921002404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699350918 | NPI | - | NPPES |
| Q007636 | Medicaid | TN |
| Provider Name | Talea L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033527213 PECOS PAC ID: 2264758820 Enrollment ID: I20150226001434 |
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