Provider Demographics
NPI:1932484607
Name:SOUTHEAST TN HUMAN RESOURCE AGENCY
Entity Type:Organization
Organization Name:SOUTHEAST TN HUMAN RESOURCE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-949-2191
Mailing Address - Street 1:312 RESOURCE AGENCY
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-0909
Mailing Address - Country:US
Mailing Address - Phone:423-949-2191
Mailing Address - Fax:423-949-4023
Practice Address - Street 1:165 EDWARDS STREET SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:423-478-1396
Practice Address - Fax:423-478-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)