Organization
EASTER SEALS TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA S BAUMGARTNER (PRESIDENT & CEO)
(615) 292-6640
Entity
Organization
Contact information
Practice address
750 OLD HICKORY BLVD # 2-260, BRENTWOOD, TN 37027-4528
(615) 292-6640
(615) 251-0994
Mailing address
750 OLD HICKORY BLVD # 2-260, BRENTWOOD, TN 37027-4528
(615) 292-6640
(615) 251-0994
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
L000000009654
TN
251S00000X
Community/Behavioral Health Agency
Primary
L000000009653
TN
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013709
AETNA PROVIDER #
TN
01
—
3131908
BC/BS PROVIDER #
TN
05
—
323
—
TN
01
—
4078521
BC/BS DME PROVIDER #
TN
Enumeration date
01/04/2006
Last updated
02/04/2015
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