Organization · Type 2 NPI

State of Tennessee

Intellectual Disabilities Intermediate Care Facility · Greeneville, TN

NPI number 1780958454 Active

Practice location

2497 Buckingham Rd.
Greeneville, TN 37743

Call (423) 787-0824 Map

Fax (423) 787-6092

Mailing address

190 Serral Dr
Greeneville, TN 37745-3074

Specialties and licenses

TaxonomyCodeLicense
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XI000000010290 (TN)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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About NPI 1780958454

State of Tennessee's National Provider Identifier is 1780958454, issued on Feb 28, 2012. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Greeneville, TN. The record was last updated on Feb 28, 2012.