Rivendell Center Llc in Maryville - Clinical
Rivendell Center Llc - NPI 1720097975
Rivendell Center Llc is a Clinical in Maryville, Tennessee. Rivendell Center Llc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Rivendell Center Llc is 1720097975. The last update date is 2007-10-04.
Rivendell Center Llc's current location address is 120 Wilson Ave, Maryville, Tennessee. You can contact this provider via phone number 8656814914 and fax number 8659779573. The mailing address for Rivendell Center Llc is 120 Wilson Ave, Maryville, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Rivendell Center Llc |
|---|---|
| Address | 120 Wilson Ave, Maryville, Tennessee |
| Phone Number | 8656814914 |
| Fax Number | 8659779573 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER MANA |
|---|---|
| Authorized Official Name | Gallagher L Patricia |
| Credentials | LCSW |
| Telephone Number | 8656814914 |
NPI Number Detail
| NPI Number | 1720097975 |
|---|---|
| Provider Enumeration Date | 2006-08-05 |
| Last Updated Date | 2007-10-04 |
Provider Mailing Address Detail
| Address | 120 Wilson Ave |
|---|---|
| City | Maryville |
| State | Tennessee (TN) |
| Post Code | 378036051 |
| Phone Number | 8656814914 |
| Fax Number | 8659779573 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LSW000000396 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3922162 | TN | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Rivendell Center Llc by the Centers for Medicare & Medicaid Services?
The Rivendell Center Llc has been issued the NPI (National Provider Identifier) 1720097975, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Rivendell Center Llc is physically located?
The Rivendell Center Llc is physically situated at the following address: 120 Wilson Ave, Maryville, TN, 378036051.
What is the area of specialization for Rivendell Center Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Rivendell Center Llc is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1720097975 to Rivendell Center Llc?
The Centers for Medicare & Medicaid Services assigned the 1720097975 to Rivendell Center Llc on 2006-08-05.
When was the Rivendell Center Llc's information last updated?
The Rivendell Center Llc's information was last updated on 2007-10-04.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC