Organization
TEN BROECK TENNESSEE PHYSICIANS GROUP INC
Active
Parent organization
TEN BROECK TENNESSEE PHYSICIANS GROUP INC
Other names
Memorial Senior Counseling Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEN BROECK TENNESSEE PHYSICIANS GROUP INC
Authorized official
GLENDA F GUY (DIRECTOR, COMPLIANCE)
(931) 783-2511
Entity
Organization
Contact information
Practice address
45OO MEMORIAL DRIVE, BELLEVILLE, IL 62226-5399
(618) 257-5900
(618) 257-5463
Mailing address
1 MEDICAL CENTER BLVD, COOKEVILLE, TN 38501-4294
(931) 783-2511
(931) 783-2550
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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