Southeastern Human Services

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

L219-107-6738 Issued in TN

Legal business name

SOUTHEASTERN HUMAN SERVICES

Doing business as

Country View Estates

Practice address

1895 Highway 138
Toone, TN 38381-8128

Phone

(731) 658-4629

Fax

(731) 659-2999

NPI assigned

Dec 2, 2008

Last updated

Dec 2, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dana Denise Jones

Title

Executive Director

Phone

(731) 616-1456

Specialties & licenses 2

Addresses

Other names 1

• Country View Estates Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1275788408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 STONEBRIDGE BLVD",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052160",
            "telephone_number": "731-660-5311",
            "fax_number": "731-660-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 HIGHWAY 138",
            "city": "TOONE",
            "state": "TN",
            "postal_code": "383818128",
            "telephone_number": "731-658-4629",
            "fax_number": "731-659-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-616-1456"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "L219-107-6737",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "L219-107-6738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country View Estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Toone, TN
• Providers in Toone, TN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.