Provider Demographics
NPI:1265579163
Name:EAST TN HUMAN RESOURCE AGENCY
Entity type:Organization
Organization Name:EAST TN HUMAN RESOURCE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ACUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-691-2551
Mailing Address - Street 1:9111 CROSS PARK DR STE D100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4517
Mailing Address - Country:US
Mailing Address - Phone:865-691-2551
Mailing Address - Fax:865-251-0055
Practice Address - Street 1:9111 CROSS PARK DR STE D100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4517
Practice Address - Country:US
Practice Address - Phone:865-691-2551
Practice Address - Fax:865-251-0055
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)