Organization
STATE OF TENNESSEE
Active
Other names
DIDD EAST TN HOMES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGI STORY (EAST TN HOMES DIRECTOR)
(423) 787-6757
Entity
Organization
Contact information
Practice address
855 MEADOWBROOK RD, AFTON, TN 37616-6047
(423) 787-6757
(423) 798-6253
Mailing address
190 SERRAL DR, GREENEVILLE, TN 37745-3074
(423) 787-6757
(423) 798-6253
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7447148
—
TN
Enumeration date
09/20/2010
Last updated
06/09/2011
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