Organization · Type 2 NPI

State of Tennessee

Intellectual Disabilities Intermediate Care Facility · Greeneville, TN

NPI number 1871997163 Active

Practice location

803 Redbud Dr
Greeneville, TN 37743-6141

Call (423) 525-5299 Map

Fax (423) 787-6465

Mailing address

PO Box 309
Greeneville, TN 37744-0309

Specialties and licenses

TaxonomyCodeLicense
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XI000000013242 (TN)

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

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About NPI 1871997163

State of Tennessee's National Provider Identifier is 1871997163, issued on Oct 15, 2014. 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 Oct 15, 2014.