MICHAEL DUNN CENTER NPI 1003950692

NPI Information

NPI: 1003950692
Provider Name: MICHAEL DUNN CENTER

Other Name: JULIA CAILLOUETTE HOME

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
106 VILLAGE TRCE
KINGSTON, TN
ZIP 37763
Phone: (865) 376-3416
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MICHAEL DUNN CENTER is an intermediate care facility mentally retarded in Kingston, TN. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MICHAEL DUNN CENTER NPI is 1003950692. The provider is registered as an organization entity type.
The provider Other Name Is Julia Caillouette Home.

The provider's business location address is:

106 VILLAGE TRCE
KINGSTON, TN
ZIP 37763-066
Phone: (865) 376-3416
Fax: (865) 717-4858

The provider's authorized official is Tracey Taylor .
The authorized official title is Residential Accountant and has the following contact phone number (865) 376-3416.

The enumeration date for this NPI number is 2/16/2007 and was last updated on 10/27/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		L 323-056-1347	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7447111	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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