| NPI | 1316040223 |
|---|---|
| Doing Business As | THIRD AVENUE CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRIAN PHILLIP FARLEY VP & Secretary 615-861-6000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA CA10175-M) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-10-02 |