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General NPI Number Information
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NPI Number | 1295006880
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Entity Type | Organization
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Legal Business Name | TAMARLANE INDUSTRIES, INC.
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 846 S MAIN ST
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City | BEAVER DAM
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State | KY
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Zip | 42320-2156
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Country | US
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Telephone | 270-274-4534
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Fax | 270-274-9204
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Provider Business Mailing Address
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Address Line | 846 S MAIN ST
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City | BEAVER DAM
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State | KY
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Zip | 42320-2156
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Country | US
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Telephone | 270-274-4534
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Fax | 270-274-9204
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Authorized Official
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Title or Position | PRESIDENT OF BOARD OF DIRECTORS
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Name | BILL WILSON
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Credential |
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Telephone | 270-274-4534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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