Organization
STATE OF TENNESSEE, GREENE VALLEY DEVELOPMENTAL CENTER
Active
Other names
Green Valley Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN C. LOVE (ASST. CHIEF OFFICER FOR ADMIN.)
(423) 787-6572
Entity
Organization
Contact information
Practice address
4850 E ANDREW JOHNSON HWY, GREENEVILLE, TN 37745-3098
(423) 787-6800
(423) 787-6975
Mailing address
4850 E ANDREW JOHNSON HWY (37745-3098), P.O. BOX 910, GREENEVILLE, TN 37744-0910
(423) 787-6800
(423) 787-6975
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
L 323-106-1620
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-7014
—
TN
Enumeration date
02/05/2007
Last updated
06/30/2008
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