PARKWEST MEDICAL CENTER NPI 1427132786

NPI Information

NPI: 1427132786
Provider Name: PARKWEST MEDICAL CENTER

Doing Business As: PENINSULA VILLAGE A DIVISION OF PARKWEST MEDICAL CENTER

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization

Address:
2341 JONES BEND RD
LOUISVILLE, TN
ZIP 37777
Phone: (865) 970-9800
Get Directions

PARKWEST MEDICAL CENTER is a residential treatment facility emotionally disturbed children in Louisville, TN. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. PARKWEST MEDICAL CENTER NPI is 1427132786. The provider is registered as an organization entity type.
The provider Is Doing Business As Peninsula Village A Division Of Parkwest Medical Center.

The provider's business location address is:

2341 JONES BEND RD
LOUISVILLE, TN
ZIP 37777
Phone: (865) 970-9800
Fax: (865) 380-1461

The provider's authorized official is John T Geppi .
The authorized official title is Executive Vice President Cfo and has the following contact phone number (865) 374-6872.

The CLIA number assigned to this NPI record is 44D0898487 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 8/22/2020.

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	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		L2370761471	TENNESSEE	Yes
2	324500000X	Substance Abuse Rehabilitation Facility		L2370761471	TENNESSEE	X

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	0440173	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: 4/28/2024

NPI Synchronization or Removal

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