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Organization
O'BRIEN
Active
Organization
O'BRIEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY THOMAS (EXECUTIVE DIRECTOR)
(423) 638-3926
Entity
Organization
Contact information
Practice address
100 PENNSYLVANIA AVE, GREENEVILLE, TN 37743-4624
(423) 638-3926
(423) 638-1105
Mailing address
100 PENNSYLVANIA AVE, GREENEVILLE, TN 37743-4624
(423) 638-3926
(423) 638-1105
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
L000000015027
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L000000017000
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7447102
ICF-MR
TN
Enumeration date
07/09/2008
Last updated
11/20/2020
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