Provider Demographics
NPI:1295006880
Name:TAMARLANE INDUSTRIES, INC.
Entity Type:Organization
Organization Name:TAMARLANE INDUSTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-274-4534
Mailing Address - Street 1:846 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:KY
Mailing Address - Zip Code:42320-2156
Mailing Address - Country:US
Mailing Address - Phone:270-274-4534
Mailing Address - Fax:270-274-9204
Practice Address - Street 1:846 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:KY
Practice Address - Zip Code:42320-2156
Practice Address - Country:US
Practice Address - Phone:270-274-4534
Practice Address - Fax:270-274-9204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services