NPI 1215200118

State of Tennessee

Organisation Intellectual Disabilities Intermediate Care Facility Greeneville, TN

Practice location

Address: 2495 Buckingham Road, Greeneville, TN 37743
Phone: (423) 787-0414
Fax: (423) 787-6092
Mailing address: 190 Serral Dr, Greeneville, TN 37745-3074

Authorised official

Name: Margi E Story
Title: Director
Phone: (423) 787-6757

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence I000000010289 (TN)

Other Intermediate Care Facility, Intellectual Disabilities providers in Tennessee →

Registry record

NPI: 1215200118
Entity type: Organization
NPI issued: 23 Feb 2012
Record last updated: 23 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.