# TEN BROECK TENNESSEE PHYSICIANS GROUP INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vibrant Living: A Program For Seniors
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265022974
- **Authorized official:** GLENDA F GUY (DIRECTOR, COMPLIANCE)
- **Authorized official phone:** (931) 607-6513

## Contact information

- **Practice address:** 819 N 1ST ST, DENNISON, OH 44621-1003
- **Practice address phone:** (740) 922-7415
- **Practice address fax:** (740) 922-7413
- **Mailing address:** PO BOX 1100, WINDERMERE, FL 34786-1100
- **Mailing address phone:** (931) 607-6513
- **Mailing address fax:** (407) 876-9170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0805X | Geriatric Psychiatry Physician | — | NULL | Yes |
| 2084P0805X | Geriatric Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2021
- **Last updated:** 01/26/2021