# UPPER EAST TN REGIONAL JUVENILE DETENTION CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326147331
- **Authorized official:** RALPH SPARKS (ADMIN)
- **Authorized official phone:** (423) 282-2118

## Contact information

- **Practice address:** 307 WESLEY ST, JOHNSON CITY, TN 37601-1721
- **Practice address phone:** (423) 282-2118
- **Practice address fax:** (423) 282-9669
- **Mailing address:** 307 WESLEY ST, JOHNSON CITY, TN 37601-1721
- **Mailing address phone:** (423) 282-2118
- **Mailing address fax:** (423) 282-9669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 08/22/2020