Organization
EMMANUEL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DANA RENA MOBBS (ADMINISTRATOR/OWNER)
(931) 231-5905
Entity
Organization
Contact information
Practice address
101 MAIN STREET, ETHRIDGE, TN 38456
(931) 231-5905
Mailing address
2773 HIGHWAY 43 N, LAWRENCEBURG, TN 38464-6057
(931) 231-5514
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1000000005014
TN
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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