Organization
MICHAEL DUNN CENTER
Active
Other names
Julia Caillouette Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACEY TAYLOR (RESIDENTIAL ACCOUNTANT)
(865) 376-3416
Entity
Organization
Contact information
Practice address
106 VILLAGE TRCE, KINGSTON, TN 37763-7066
(865) 376-3416
(865) 717-4858
Mailing address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
(865) 717-4858
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
L 323-056-1347
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7447111
—
TN
Enumeration date
02/16/2007
Last updated
10/27/2011
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