Provider Demographics
NPI:1124672704
Name:TRISTAR MAURY BEHAVIORAL HEALTHCARE, LLC
Entity type:Organization
Organization Name:TRISTAR MAURY BEHAVIORAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHISOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-381-1111
Mailing Address - Street 1:1000 HEALTH PARK DR STE 500
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5580
Mailing Address - Country:US
Mailing Address - Phone:931-381-1111
Mailing Address - Fax:
Practice Address - Street 1:1001 N JAMES M CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2689
Practice Address - Country:US
Practice Address - Phone:931-777-6000
Practice Address - Fax:931-777-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital