State of Tennessee Greene Valley Developmental Center
NPI #1811159072 in Greeneville, Tennessee
Provider Information
- NPI Number
- 1811159072
- Entity Type
- Organization
- Organization Name
- State of Tennessee Greene Valley Developmental Center
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- STATE OF TENNESSEE
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jun 30, 2008
- Last Updated
- Jun 30, 2008
Practice Location
- Address
- 4850 E ANDREW JOHNSON HWY
- City
- Greeneville
- State
- Tennessee
- ZIP Code
- 37745-3098
- Phone
- (423) 787-6570
Authorized Official
- Name
- MR. GARY D SIMCOX, CPA CGFM
- Title
- FISCAL DIRECTOR 1
- Phone
- (423) 787-6570
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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