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General NPI Number Information
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NPI Number | 1164012068
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH OF ROCKY TOP, LLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 210 INDUSTRIAL PARK LN
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City | ROCKY TOP
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State | TN
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Zip | 37769-2301
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Country | US
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Telephone | 865-392-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 210 INDUSTRIAL PARK LN
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City | ROCKY TOP
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State | TN
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Zip | 37769-2301
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Country | US
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Telephone | 865-392-9200
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Fax |
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Authorized Official
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Title or Position | AR MANAGER
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Name | JOHN HARRELL
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Credential |
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Telephone | 865-218-8966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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