State of Tennessee
NPI #1629342415 in Greeneville, Tennessee
Provider Information
- NPI Number
- 1629342415
- Entity Type
- Organization
- Organization Name
- State of Tennessee
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Feb 27, 2012
- Last Updated
- Feb 27, 2012
Practice Location
- Address
- 102 DYER ST.
- City
- Greeneville
- State
- Tennessee
- ZIP Code
- 37743
- Phone
- (423) 787-0879
Authorized Official
- Name
- MRS. MARGI E STORY
- Title
- DIRECTOR
- Phone
- (423) 787-6757
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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