# STATE OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Department of Intellectual and Developmental Disabilities
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467723155
- **Authorized official:** DAVID COMM (DIRECTOR OF BUSINESS SERVICES)
- **Authorized official phone:** (629) 267-8103

## Contact information

- **Practice address:** 2107 SUSONG RD, GREENEVILLE, TN 37743-4944
- **Practice address phone:** (423) 787-0673
- **Mailing address:** 315 DEADERICK ST FL 8, NASHVILLE, TN 37238-3000
- **Mailing address fax:** (615) 253-6713

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | I000000010134 | TN | — |

## Other

- **Enumeration date:** 01/26/2012
- **Last updated:** 07/05/2023