Provider Demographics
NPI:1336682830
Name:TRULA CRONK HOME FOR CHILDREN LLC
Entity Type:Organization
Organization Name:TRULA CRONK HOME FOR CHILDREN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-639-9449
Mailing Address - Street 1:90 STANLEY LN
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-6066
Mailing Address - Country:US
Mailing Address - Phone:423-639-9449
Mailing Address - Fax:423-639-0242
Practice Address - Street 1:90 STANLEY LN
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-6066
Practice Address - Country:US
Practice Address - Phone:423-639-9449
Practice Address - Fax:423-639-0242
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREE WILL BAPTIST FAMILY MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000019198324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility