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Organization
OUR HOME PLACE
Active
Organization
OUR HOME PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY MCKEE (CHIEF OPERATING OFFICER)
(423) 612-8628
Entity
Organization
Contact information
Practice address
305 SPEARHEAD CIR, KINGSPORT, TN 37664-6200
(423) 323-5092
(423) 323-5092
Mailing address
305 SPEARHEAD CIR, KINGSPORT, TN 37664-6200
(423) 323-5092
(423) 323-5092
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
01/03/2015
Last updated
01/03/2015
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