Provider Demographics
NPI:1316257629
Name:SCALES NUTRITION AND WELLNESS CENTER
Entity type:Organization
Organization Name:SCALES NUTRITION AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:615-724-0865
Mailing Address - Street 1:1010 4TH AVE NORTH
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219
Mailing Address - Country:US
Mailing Address - Phone:615-724-0865
Mailing Address - Fax:615-724-0871
Practice Address - Street 1:1010 4TH AVE NORTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219
Practice Address - Country:US
Practice Address - Phone:615-724-0865
Practice Address - Fax:615-724-0871
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCALES NUTRITION AND WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36454261QA0600X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH17693Medicare UPIN