IndividualActive
Mary Hane
NPI 1144623620 · Mental Illness Community Based Residential Treatment Facility · Tullahoma, TN
Provider details
- NPI number
- 1144623620
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 621674308 (TN)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense 621674308 (TN)
Residential Treatment Facilities
Practice location
207 W Blackwell St
Tullahoma, TN 37388-3395
Phone: (931) 461-0290
Approximate (ZIP-level) locationGet directions
Mailing address
11331 Tullahoma Hwy
Tullahoma, TN 37388-6015
Registry dates
- Enumerated
- 2014-09-29
- Last updated
- 2014-09-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.