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State Of Tennessee
Intellectual Disabilities Intermediate Care Facility in Greeneville, Tennessee
NPI 1215200118

State Of Tennessee is a Intellectual Disabilities Intermediate Care Facility based in Greeneville, TN. State Of Tennessee practices in Greeneville, TN. The NPI Number for State Of Tennessee is 1215200118 and holds a License No. I000000010289 (Tennessee).

The current practice location address for State Of Tennessee is 2495 Buckingham Road, Greeneville, TN and can be reached out via phone at 423-787-0414 and via fax at 423-787-6092.

Location: 2495 Buckingham Road, Greeneville, TN, 37745-3074
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215200118
Provider Name
State Of Tennessee
Credential
Provider Entity Type
Organization
Address
2495 Buckingham Road, Greeneville, TN, 37745-3074
Phone Number
423-787-0414
Fax Number
423-787-6092
Provider Enumeration Date
02/23/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
31500000X 01 TN TAXONOMY
institution
Provider Business Practice Location Address Details
Address
2495 Buckingham Road
City
Greeneville
State
Tennessee
Zip
37743
Phone Number
423-787-0414
Fax Number
423-787-6092
person
Provider Business Mailing Address Details
Address
2495 Buckingham Road
City
Greeneville
State
Tennessee
Zip
37743
Phone Number
423-787-0414
Fax Number
423-787-6092
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
I000000010289 (Tennessee)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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