Provider Demographics
NPI:1346517463
Name:EXCEPTIONAL ENTERPRISES, INC.
Entity Type:Organization
Organization Name:EXCEPTIONAL ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:LINGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-692-2235
Mailing Address - Street 1:23 N INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:COALMONT
Mailing Address - State:TN
Mailing Address - Zip Code:37313-2501
Mailing Address - Country:US
Mailing Address - Phone:931-692-2235
Mailing Address - Fax:931-692-2244
Practice Address - Street 1:23 N INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:COALMONT
Practice Address - State:TN
Practice Address - Zip Code:37313-2501
Practice Address - Country:US
Practice Address - Phone:931-692-2235
Practice Address - Fax:931-692-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL08065251C00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN365Medicaid