Provider Demographics
NPI:1073657136
Name:EMORY VALLEY CENTER
Entity Type:Organization
Organization Name:EMORY VALLEY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CUPP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:865-813-0595
Mailing Address - Street 1:723 EMORY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7017
Mailing Address - Country:US
Mailing Address - Phone:865-483-4385
Mailing Address - Fax:865-482-5435
Practice Address - Street 1:723 EMORY VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7017
Practice Address - Country:US
Practice Address - Phone:865-483-4385
Practice Address - Fax:865-482-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL00000008624251C00000X, 252Y00000X
TNL00000008623251C00000X, 320900000X
TNL00000009262251C00000X
TNL00000008622251C00000X
TNL0000000008622253Z00000X
261QH0700X, 261QM0850X, 343900000X
TNL00000008625320600000X
TNL00000008626320600000X
TNL00000008627320600000X
TNL00000008628320600000X
TNL00000008629320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)