Healthcare Provider Details

I. General information

NPI: 1528129590
Provider Name (Legal Business Name): HARDIN COUNTY SKILLS, IN.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 NORTHWOOD DR
SAVANNAH TN
38372-1703
US

IV. Provider business mailing address

PO BOX 666
SAVANNAH TN
38372-0666
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-4039
  • Fax: 731-925-5679
Mailing address:
  • Phone: 731-925-4039
  • Fax: 731-925-5679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberL3(20)4M3-066-6246
License Number StateTN

VIII. Authorized Official

Name: MRS. ANNA H ROBINSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 731-925-4039