Provider Demographics
NPI:1184655284
Name:THERAPEUTIC SERVICES OF MORRISTOWN INC.
Entity Type:Organization
Organization Name:THERAPEUTIC SERVICES OF MORRISTOWN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L
Authorized Official - Phone:423-748-4800
Mailing Address - Street 1:5250 W. ANDREW JOHNSON HWY.
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-1027
Mailing Address - Country:US
Mailing Address - Phone:423-318-7800
Mailing Address - Fax:423-317-3332
Practice Address - Street 1:5250 W. ANDREW JOHNSON HWY.
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-1027
Practice Address - Country:US
Practice Address - Phone:423-748-4800
Practice Address - Fax:423-317-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN225100000X
TNOT00573225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3735744Medicaid
TN3735744Medicaid