Healthcare Provider Details

I. General information

NPI: 1285607515
Provider Name (Legal Business Name): SEVIERVILLE SENIOR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 DOLLY PARTON PKWY
SEVIERVILLE TN
37862-3961
US

IV. Provider business mailing address

707 DOLLY PARTON PKWY
SEVIERVILLE TN
37862-3961
US

V. Phone/Fax

Practice location:
  • Phone: 865-428-5614
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENDA ELLIS
Title or Position: PRIVACY OFFICER
Credential: RHIT
Phone: 865-549-2121