Hot Rod Shannon, Inc.

NPI #1659648764 in Wartburg, Tennessee

Provider Information

NPI Number: 1659648764
Entity Type: Organization
Organization Name: Hot Rod Shannon, Inc.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 18, 2011
Last Updated: Nov 18, 2011

Practice Location

Address: 2303 MORGAN COUNTY HWY
City: Wartburg
State: Tennessee
ZIP Code: 37887-3528
Phone: (423) 346-4630

Authorized Official

Name: ALICE FREELS
Title: PRESIDENT
Phone: (423) 539-2757

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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