Provider Demographics
NPI:1306321179
Name:YARROW LODGE, LLC
Entity type:Organization
Organization Name:YARROW LODGE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP - CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-382-3319
Mailing Address - Street 1:1000 HEALTH PARK DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5577
Mailing Address - Country:US
Mailing Address - Phone:615-386-7255
Mailing Address - Fax:
Practice Address - Street 1:10677 N 48TH STREET
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:MI
Practice Address - Zip Code:49012
Practice Address - Country:US
Practice Address - Phone:269-282-7721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUAL DIAGNOSIS MANAGEMENT, LLC DBA PALMSPRINGS SERENITY RETREAT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-27
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility