Organization
MICHAEL DUNN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCELHINNEY (PRESIDENT/CEO)
(865) 376-3416
Entity
Organization
Contact information
Practice address
763 CLYMERSVILLE RD, ROCKWOOD, TN 37854-6508
(865) 376-3416
(865) 376-3532
Mailing address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
(865) 376-3532
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
L000000014939
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G705293
MEDICARE PTAN
—
Enumeration date
10/10/2016
Last updated
11/25/2016
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