Organization
QUALITY OF LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON PAYNE (EXECUTIVE DIRECTOR)
(423) 718-2328
Entity
Organization
Contact information
Practice address
22130 RHEA COUNTY HWY, SPRING CITY, TN 37381-5243
(423) 718-2328
(423) 365-0761
Mailing address
22130 RHEA CO HWY, SPRING CITY, TN 37381
(423) 718-2328
(423) 365-0761
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
159069
TN
251J00000X
Nursing Care Agency
Primary
159069
TN
253Z00000X
In Home Supportive Care Agency
—
—
305R00000X
Preferred Provider Organization
LPN0000052001
TN
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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