Organization
HOT ROD SHANNON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE FREELS (PRESIDENT)
(423) 539-2757
Entity
Organization
Contact information
Practice address
2303 MORGAN COUNTY HWY, WARTBURG, TN 37887-3528
(423) 346-4630
(423) 346-4631
Mailing address
2303 MORGAN COUNTY HWY, WARTBURG, TN 37887-3528
(423) 346-4630
(423) 346-4631
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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