Provider Demographics
NPI:1447942958
Name:NEUROSAIL CLINIC
Entity type:Organization
Organization Name:NEUROSAIL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIANLAI
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-260-1949
Mailing Address - Street 1:110 GLANCY ST STE 114
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2314
Mailing Address - Country:US
Mailing Address - Phone:615-457-8585
Mailing Address - Fax:
Practice Address - Street 1:110 GLANCY ST STE 114
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2314
Practice Address - Country:US
Practice Address - Phone:615-457-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NASHVILLE BRAIN INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)