IndividualActive
Indya Daniels
NPI 1780208116 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jackson, TN
Provider details
- NPI number
- 1780208116
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
262 Carriage House Dr
Jackson, TN 38305-2228
Phone: (731) 616-5221
Approximate (ZIP-level) locationGet directions
Mailing address
262 Carriage House Dr
Jackson, TN 38305-2228
Registry dates
- Enumerated
- 2020-06-01
- Last updated
- 2020-06-01
- Certified
- 2020-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.