Provider Demographics
NPI:1932592953
Name:GENERATIONS BEHAVIORAL HEALTH LLC,
Entity type:Organization
Organization Name:GENERATIONS BEHAVIORAL HEALTH LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ARDELL
Authorized Official - Last Name:STACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-400-2333
Mailing Address - Street 1:4235 HILLSBORO PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3344
Mailing Address - Country:US
Mailing Address - Phone:615-669-9716
Mailing Address - Fax:
Practice Address - Street 1:4423 FORSYTHE PLACE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-400-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital