State of TN
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Chuckey, TN
NPI 1982999777 · NPPES record last updated Jun 9, 2011
Key facts
- NPI
- 1982999777
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- Legal business name
- STATE OF TN
- Practice address
- 143 Delzie Randolph Rd
Chuckey, TN 37641-6247 - Phone
- (423) 787-6757
- Fax
- (423) 798-6253
- NPI assigned
- Jun 9, 2011
- Organization subpart
- No
Authorized official
- Name
- Mrs. Margi Story
- Title
- East TN Homes Director
- Phone
- (423) 787-6757
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Yes |
Addresses
Primary practice location
143 Delzie Randolph Rd
Chuckey, TN 37641-6247
Mailing address
190 Serral Dr
Greeneville, TN 37745-3074
Phone (423) 787-6757
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7447158 | Medicaid | TN |
Other names
- DIDS EAST TN HOMES
Other providers in Chuckey, TN
All providers in Chuckey, TN · Intellectual Disabilities Intermediate Care Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.