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NPI Code Detail

MEDICARE: BEHAVIORAL HEALTH OF ROCKY TOP, LLC

MEDICARE: BEHAVIORAL HEALTH OF ROCKY TOP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital

General Provider Information

NPI Number : 1174033906
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIORAL HEALTH OF ROCKY TOP, LLC
Provider Business Mailing Address
First Line : PO BOX 23376
Second Line :
City : KNOXVILLE
State : TN
Zip : 37933-1376
Country : US
Telephone Number : 865-218-8966
Fax Number :
Provider Business Practice Location Address
First Line : 210 INDUSTRIAL PARK DR
Second Line :
City : ROCKY TOP
State : TN
Zip : 37769-2301
Country : US
Telephone Number : 865-218-8966
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RON LAWRENCE
Credential :
Telephone Number : 865-218-8966
Provider Enumeration Date : 10/06/2017
Last Update Date : 01/20/2021

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Directions to “BEHAVIORAL HEALTH OF ROCKY TOP, LLC ” Practice Location

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