Provider Demographics
NPI:1043663495
Name:TENNESSEE CHILDREN'S HOME
Entity Type:Organization
Organization Name:TENNESSEE CHILDREN'S HOME
Other - Org Name:TENNESSEE CHILDREN'S HOME EAST CAMPUS
Other - Org Type:Other Name
Authorized Official - Title/Position:TREATMENT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:865-584-0841
Mailing Address - Street 1:8550 HAROLD DUNCAN WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931
Mailing Address - Country:US
Mailing Address - Phone:865-584-0841
Mailing Address - Fax:865-415-2191
Practice Address - Street 1:8550 HAROLD DUNCAN WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931
Practice Address - Country:US
Practice Address - Phone:865-584-0841
Practice Address - Fax:865-415-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children