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Organization

TEN BROECK TENNESSEE PHYSICIANS

Active
Parent organization
TEN BROECK TENNESSEE PHYSICIANS
Other names
CHI St. Joseph Health Madison Hospital d/b/a Senior Renewal Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
TEN BROECK TENNESSEE PHYSICIANS
Authorized official
GLENDA F GUY (DIRECTOR, COMPLIANCE)
(931) 783-2511
Entity
Organization

Contact information

Practice address
11110 WOODSON DRIVE, CALDWELL, TX 77836-1053
(936) 567-2273
(936) 567-2274
Mailing address
1 MEDICAL CENTER BLVD, COOKEVILLE, TN 38501-4294
(931) 783-2511

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
10/04/2019
Last updated
12/11/2019
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