Provider Demographics
NPI:1811915838
Name:TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC.
Entity type:Organization
Organization Name:TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-636-2376
Mailing Address - Street 1:401 TAKOMA AVE
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-4647
Mailing Address - Country:US
Mailing Address - Phone:423-639-3151
Mailing Address - Fax:423-636-2374
Practice Address - Street 1:401 TAKOMA AVE
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4647
Practice Address - Country:US
Practice Address - Phone:423-639-3151
Practice Address - Fax:423-636-2374
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAKOMA ADVENTIST HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000054273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA3774401OtherTC JOHN DEERE MCAID
TNA3774301OtherMEDICARE MANAGED CARE
TN1000393OtherBLUE CROSS
TN3278734OtherMEDICARE PART B GROUP #
TNA3774401OtherJOHN DEERE HEALTH PLAN
TN1000393OtherTC BLUE CARE
TN1000393OtherTC TENNCARE SELECT
TN4400050Medicaid
TN3924507OtherMEDICARE LCSW GROUP
TNA3774401OtherTC JOHN DEERE MCAID
TN1000393OtherTC BLUE CARE
TN3278734OtherMEDICARE PART B GROUP #
TN=========OtherTRICARE
TN=========001OtherTRICARE
TN=========OtherTC TENNESSEE BEHAVIORAL