Organization
BIOS OF TENNESSEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI MOUSE (CHIEF FINANCIAL OFFICER)
(918) 227-8390
Entity
Organization
Contact information
Practice address
2855 STAGE VILLAGE CV, BARTLETT, TN 38134-4616
(901) 388-0258
(901) 388-4254
Mailing address
309 E DEWEY AVE, SAPULPA, OK 74066-4301
(918) 227-8390
(918) 227-8378
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B98
PROVIDER NUMBER
TN
01
—
05216W
CONTRACT NUMBER
TN
01
—
X098
LIST NUMBER
TN
Enumeration date
05/11/2007
Last updated
08/22/2020
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