Upper East Tn Regional Juvenile Detention Center
NPI #1326147331 in Johnson City, Tennessee
Provider Information
- NPI Number
- 1326147331
- Entity Type
- Organization
- Organization Name
- Upper East Tn Regional Juvenile Detention Center
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- Sep 22, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 307 WESLEY ST
- City
- Johnson City
- State
- Tennessee
- ZIP Code
- 37601-1721
- Phone
- (423) 282-2118
Authorized Official
- Name
- RALPH SPARKS
- Title
- ADMIN
- Phone
- (423) 282-2118
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
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