IndividualActive
Jeremy Beard
NPI 1033827852 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jackson, TN
Provider details
- NPI number
- 1033827852
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
131 Tucker St # 11
Jackson, TN 38301-4055
Phone: (731) 217-6103
Approximate (ZIP-level) locationGet directions
Mailing address
131 Tucker St # 11
Jackson, TN 38301-4055
Registry dates
- Enumerated
- 2022-11-10
- Last updated
- 2022-11-10
- Certified
- 2022-11-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.