Provider Demographics
NPI:1336272350
Name:TANNERHILL, INC.
Entity Type:Organization
Organization Name:TANNERHILL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-568-3650
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:35 HIGH STREET
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-0414
Mailing Address - Country:US
Mailing Address - Phone:401-568-3650
Mailing Address - Fax:401-568-4207
Practice Address - Street 1:35 HIGH ST
Practice Address - Street 2:
Practice Address - City:PASCOAG
Practice Address - State:RI
Practice Address - Zip Code:02859-2620
Practice Address - Country:US
Practice Address - Phone:401-568-3650
Practice Address - Fax:401-568-4207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIT103861322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children