Provider Demographics
NPI:1710131313
Name:TENNESSEE COMMUNITY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:TENNESSEE COMMUNITY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TROLAN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:INGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CAHM
Authorized Official - Phone:865-397-1038
Mailing Address - Street 1:878 HIGHWAY 92 S
Mailing Address - Street 2:
Mailing Address - City:DANDRIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37725-4621
Mailing Address - Country:US
Mailing Address - Phone:865-397-1038
Mailing Address - Fax:865-397-6820
Practice Address - Street 1:882 HIGHWAY 92 S
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4621
Practice Address - Country:US
Practice Address - Phone:865-397-9889
Practice Address - Fax:865-397-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8011784251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509740Medicaid
TN1509740Medicaid