Organization
TRI-COUNTY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA WADE PERDUE (EXECUTIVE DIRECTOR)
(423) 745-8902
Entity
Organization
Contact information
Practice address
3030 LEE HWY, ATHENS, TN 37303-5062
(423) 745-8902
(423) 745-8934
Mailing address
PO BOX 793, ATHENS, TN 37371-0793
(423) 745-8902
(423) 745-8934
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
L3(20)M2-086-1505
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00106
DMRS PROVIDER NUMBER
TN
Enumeration date
01/31/2007
Last updated
08/22/2020
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