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Amanda Dawn Self
Mental Illness Intermediate Care Facility in Tennessee Ridge, Tennessee
NPI 1245815109

Amanda Dawn Self is a Mental Illness Intermediate Care Facility based in Erin, TN. Amanda Dawn Self practices in Tennessee Ridge, TN. The NPI Number for Amanda Dawn Self is 1245815109 and holds a License No. (Tennessee).

The current practice location address for Amanda Dawn Self is 1330 N Main St, Tennessee Ridge, TN and can be reached out via phone at 888-291-4357.

Location: 1330 N Main St, Tennessee Ridge, TN, 37061-6098
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245815109
Provider Name
Amanda Dawn Self
Credential
Provider Entity Type
Individual
Gender
Female
Address
1330 N Main St, Tennessee Ridge, TN, 37061-6098
Phone Number
888-291-4357
Fax Number
Provider Enumeration Date
03/12/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1330 N Main St
City
Tennessee Ridge
State
Tennessee
Zip
37178-4003
Phone Number
888-291-4357
Fax Number
person
Provider Business Mailing Address Details
Address
1330 N Main St
City
Tennessee Ridge
State
Tennessee
Zip
37178-4003
Phone Number
888-291-4357
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mental Illness
Speciality
-
Taxonomy
310500000X
License No.
()
Definition
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
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