| Azaela Trace Assisted Living | |
|
319 Plus Park Blvd Nashville TN 37217-1098 | |
| (615) 915-4074 | |
| (615) 942-6342 |
| Full Name | Azaela Trace Assisted Living |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 319 Plus Park Blvd, Nashville, Tennessee |
| Authorized Official Name and Position | Thelma Dees-johnson (LPC-MHSP) |
| Authorized Official Contact | 61591504074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Azaela Trace Assisted Living Po Box 132 Old Hickory TN 37138-0132 Ph: (615) 915-4074 | Azaela Trace Assisted Living 319 Plus Park Blvd Nashville TN 37217-1098 Ph: (615) 915-4074 |
| NPI Number | 1447532205 |
|---|---|
| Provider Enumeration Date | 09/16/2011 |
| Last Update Date | 06/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447532205 | NPI | - | NPPES |
| H445718 | Medicaid | TN | |
| 5442020 | Medicaid | TN |
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