Provider Demographics
NPI:1184659229
Name:RIDGEVIEW PSYCHIATRIC HOSPITAL AND CENTER, INC.
Entity Type:Organization
Organization Name:RIDGEVIEW PSYCHIATRIC HOSPITAL AND CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-482-1076
Mailing Address - Street 1:240 W TYRONE RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6517
Mailing Address - Country:US
Mailing Address - Phone:865-482-1076
Mailing Address - Fax:865-481-6179
Practice Address - Street 1:240 W TYRONE RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6517
Practice Address - Country:US
Practice Address - Phone:865-482-1076
Practice Address - Fax:865-481-6179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3273931OtherMEDICARE PART B
TN3273931OtherMEDICARE PART B
TN3273931OtherMEDICARE PART B
TN3273933OtherMEDICARE PART B