Organization
UPPER EAST TN REGIONAL JUVENILE DETENTION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH SPARKS (ADMIN)
(423) 282-2118
Entity
Organization
Contact information
Practice address
307 WESLEY ST, JOHNSON CITY, TN 37601-1721
(423) 282-2118
(423) 282-9669
Mailing address
307 WESLEY ST, JOHNSON CITY, TN 37601-1721
(423) 282-2118
(423) 282-9669
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
08/22/2020
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