STATE OF TN NPI 1881980464

NPI Information

STATE OF TN is an intermediate care facility mentally retarded in Chuckey, TN. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STATE OF TN NPI is 1881980464. The provider is registered as an organization entity type.
The provider Is Doing Business As Didd East Tn Homes.

The provider's business location address is:

590 STONE DAM RD
CHUCKEY, TN
ZIP 37641-905
Phone: (423) 787-6757
Fax: (423) 798-6253

The provider's authorized official is Margi Story .
The authorized official title is East Tn Homes Director and has the following contact phone number (423) 787-6757.

The enumeration date for this NPI number is 6/22/2011 and was last updated on 6/22/2011.

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:

Other Identifiers

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