Organization
STATE OF TENNESSEE
Active
Other names
East Tennessee Community Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MARGI E STORY (DIRECTOR)
(423) 787-6481
Entity
Organization
Contact information
Practice address
803 REDBUD DR, GREENEVILLE, TN 37743-6141
(423) 525-5299
(423) 787-6465
Mailing address
PO BOX 309, GREENEVILLE, TN 37744-0309
(423) 787-6500
(423) 787-6465
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
I000000013242
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
315P00000X
TAXONOMY
TN
05
—
PENDING
—
TN
Enumeration date
10/15/2014
Last updated
10/15/2014
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