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Organization
STATE OF TN
Active
Organization
STATE OF TN
Active
Other names
DIDS EAST TN HOMES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGI STORY (EAST TN HOMES DIRECTOR)
(423) 787-6757
Entity
Organization
Contact information
Practice address
143 DELZIE RANDOLPH RD, CHUCKEY, TN 37641-6247
(423) 787-6757
(423) 798-6253
Mailing address
190 SERRAL DR, GREENEVILLE, TN 37745-3074
(423) 787-6757
(423) 798-6253
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7447158
—
TN
Enumeration date
06/09/2011
Last updated
06/09/2011
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