Provider Demographics
NPI:1609913599
Name:TRI-COUNTY CENTER
Entity Type:Organization
Organization Name:TRI-COUNTY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-745-8902
Mailing Address - Street 1:PO BOX 793
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0793
Mailing Address - Country:US
Mailing Address - Phone:423-745-8902
Mailing Address - Fax:423-745-8934
Practice Address - Street 1:3030 LEE HWY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-5062
Practice Address - Country:US
Practice Address - Phone:423-745-8902
Practice Address - Fax:423-745-8934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL3(20)M2-086-1505251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00106OtherDMRS PROVIDER NUMBER